Provider Demographics
NPI:1083783666
Name:SEEBACH, PATRICIA A (DC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:SEEBACH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 NELSON BROGDON BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3478
Mailing Address - Country:US
Mailing Address - Phone:770-271-8949
Mailing Address - Fax:770-271-8199
Practice Address - Street 1:4530 NELSON BROGDON BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-3478
Practice Address - Country:US
Practice Address - Phone:770-271-8949
Practice Address - Fax:770-271-8199
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA005180OtherLICENSE
GAU60468Medicare UPIN
GA35ZCDZTMedicare ID - Type Unspecified