Provider Demographics
NPI:1134671100
Name:PATTON CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:PATTON CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-404-9453
Mailing Address - Street 1:101 W COLLEGE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-1124
Mailing Address - Country:US
Mailing Address - Phone:620-404-9453
Mailing Address - Fax:
Practice Address - Street 1:101 W COLLEGE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-1124
Practice Address - Country:US
Practice Address - Phone:620-404-9453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016002162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty