Provider Demographics
NPI:1710192240
Name:RATCLIFFE, ERIKA L (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:L
Last Name:RATCLIFFE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 ATHENS HWY STE J-10
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-4952
Mailing Address - Country:US
Mailing Address - Phone:770-554-5400
Mailing Address - Fax:770-554-5401
Practice Address - Street 1:910 ATHENS HWY STE J-10
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-4952
Practice Address - Country:US
Practice Address - Phone:770-554-5400
Practice Address - Fax:770-554-5401
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5365111NR0400X
SC1885111NR0400X
FLCH7169111NR0400X
MA2874111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00769623AMedicaid
GA00769623AMedicaid
GAU64991Medicare UPIN