Provider Demographics
NPI:1366020760
Name:RATZLAFF, DANIEL CHRISTIAN RICE (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHRISTIAN RICE
Last Name:RATZLAFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 S CHAUTAUQUA AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-3008
Mailing Address - Country:US
Mailing Address - Phone:620-757-0573
Mailing Address - Fax:
Practice Address - Street 1:9710 STATE AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-2232
Practice Address - Country:US
Practice Address - Phone:360-653-1742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program