Individual
JACOB M RATLIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
714 PHALEN DR APT A, COPENHAGEN, NY 13626-3116
(315) 886-4692
Mailing address
714 PHALEN DR APT A, COPENHAGEN, NY 13626-3116
(315) 886-4692
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
344965
NY
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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