Provider Demographics
NPI:1619184595
Name:RATCLIFF, MARCIA KIMBALL (PT)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:KIMBALL
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8125 TAR RIVER CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ELM CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27822
Mailing Address - Country:US
Mailing Address - Phone:704-796-1081
Mailing Address - Fax:
Practice Address - Street 1:627 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-6107
Practice Address - Country:US
Practice Address - Phone:252-459-5565
Practice Address - Fax:252-459-5568
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4753225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC346653Medicare PIN