Provider Demographics
NPI:1679589402
Name:RATCLIFF, CRAIG B (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:B
Last Name:RATCLIFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 MIDDLE CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862
Mailing Address - Country:US
Mailing Address - Phone:865-453-1390
Mailing Address - Fax:865-453-1788
Practice Address - Street 1:826 MIDDLE CREEK ROAD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862
Practice Address - Country:US
Practice Address - Phone:865-453-1390
Practice Address - Fax:865-453-1788
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3040204OtherBCBS
TN3040204OtherBCBS
T74787Medicare UPIN