Provider Demographics
NPI:1780980235
Name:RATLIFF, MISTY N (DC)
Entity type:Individual
Prefix:DR
First Name:MISTY
Middle Name:N
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MISTY
Other - Middle Name:
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1528 AZALEA DRIVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577
Mailing Address - Country:US
Mailing Address - Phone:601-746-5224
Mailing Address - Fax:601-746-5204
Practice Address - Street 1:1528 AZALEA DRIVE SOUTH
Practice Address - Street 2:
Practice Address - City:WIGGINS
Practice Address - State:MS
Practice Address - Zip Code:39577
Practice Address - Country:US
Practice Address - Phone:601-746-5224
Practice Address - Fax:601-746-5204
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor