Provider Demographics
NPI:1164591137
Name:FRANK, PATRICK W (DC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:W
Last Name:FRANK
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 1:432 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-1653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 MEADOW LN
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1229
Practice Address - Country:US
Practice Address - Phone:419-335-5851
Practice Address - Fax:419-335-6256
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2174111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0239174Medicaid
OH0093460OtherCIGNA
OH02732OtherPARAMOUNT
OH341804626-001OtherMEDICAL MUTUAL OHIO
OH000000139241OtherANTHEM BC/BS
OH0093460OtherCIGNA
OH02732OtherPARAMOUNT