MEDICARE: MR. JUSTIN RATLIFF OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	R3682	KY

General Provider Information

NPI Number	:	1972978278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JUSTIN RATLIFF OTR

Provider Business Mailing Address
First Line	:	14 AVONLEA PARK DR
Second Line	:
City	:	PARIS
State	:	KY
Zip	:	40361-1387
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6860 DALLAS PKWY STE 550
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-4252
Country	:	US
Telephone Number	:	877-899-5188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2015
Last Update Date	:	12/11/2015

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Directions to “ MR. JUSTIN RATLIFF OTR” Practice Location

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