Individual
MS. DOREEN A. RACKLIFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
255 N MAIN ST, SUITE 100, BRISTOL, CT 06010-4972
(860) 582-3942
(860) 584-6529
Mailing address
255 NORTH MAIN STREET, SUITE 100, BRISTOL, CT 06010
(860) 582-3942
(860) 584-6529
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000825
CT
Other
Enumeration date
01/04/2006
Last updated
10/28/2021
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