Provider Demographics
NPI:1154980605
Name:RATLIFF, AMBER L (MA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 FRANKLIN CIR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8544
Mailing Address - Country:US
Mailing Address - Phone:740-656-9368
Mailing Address - Fax:
Practice Address - Street 1:74 FRANKLIN CIR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8544
Practice Address - Country:US
Practice Address - Phone:740-656-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-09
Last Update Date:2019-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRQ493101172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver