Provider Demographics
NPI:1336784529
Name:RATCLIFFE, JAMISON (DC)
Entity Type:Individual
Prefix:
First Name:JAMISON
Middle Name:
Last Name:RATCLIFFE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2382
Mailing Address - Country:US
Mailing Address - Phone:781-829-6780
Mailing Address - Fax:781-829-6781
Practice Address - Street 1:208 BROADWAY
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2382
Practice Address - Country:US
Practice Address - Phone:781-829-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor