Provider Demographics
NPI:1528241825
Name:RATCLIFFE, BRIDGET MARIE (RD, LD, CDE)
Entity type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:MARIE
Last Name:RATCLIFFE
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 SANDUSKY ST
Mailing Address - Street 2:SUITE K
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3126
Mailing Address - Country:US
Mailing Address - Phone:419-450-4375
Mailing Address - Fax:888-363-3695
Practice Address - Street 1:1011 SANDUSKY ST
Practice Address - Street 2:SUITE K
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-3126
Practice Address - Country:US
Practice Address - Phone:419-450-4375
Practice Address - Fax:888-363-3695
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5299133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRAMT73071Medicare PIN