Provider Demographics
NPI:1902275092
Name:RATTLEY, MOTALEEN
Entity Type:Individual
Prefix:
First Name:MOTALEEN
Middle Name:
Last Name:RATTLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6543 OLD LUMBERTON RD
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-6267
Mailing Address - Country:US
Mailing Address - Phone:910-918-5173
Mailing Address - Fax:
Practice Address - Street 1:8225 OLD HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:NC
Practice Address - Zip Code:28438
Practice Address - Country:US
Practice Address - Phone:910-654-6030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist