Provider Demographics
NPI:1003196650
Name:RATLIFF, LELAND DOYLE II (PTA)
Entity Type:Individual
Prefix:
First Name:LELAND
Middle Name:DOYLE
Last Name:RATLIFF
Suffix:II
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 N BUFFALO DR
Mailing Address - Street 2:SILVER HILLS HEALTHCARE CTR
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7259
Mailing Address - Country:US
Mailing Address - Phone:702-952-2273
Mailing Address - Fax:702-952-2270
Practice Address - Street 1:3450 N BUFFALO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7424
Practice Address - Country:US
Practice Address - Phone:702-952-2273
Practice Address - Fax:702-952-2270
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-0183225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant