Provider Demographics
NPI:1194047894
Name:RATCLIFF, MEGAN AMELIA (PTA)
Entity type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:AMELIA
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 BILL CLINTON DR
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8652
Mailing Address - Country:US
Mailing Address - Phone:870-703-1975
Mailing Address - Fax:
Practice Address - Street 1:801 BILL CLINTON DR
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-8652
Practice Address - Country:US
Practice Address - Phone:870-703-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA 2391225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant