Provider Demographics
NPI:1245571421
Name:PATTERSON, JOE LANE (MS ,ATC)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:LANE
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MS ,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 DOUGLAS DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-3019
Mailing Address - Country:US
Mailing Address - Phone:256-689-2986
Mailing Address - Fax:256-820-8554
Practice Address - Street 1:2115 DOUGLAS DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-3019
Practice Address - Country:US
Practice Address - Phone:256-689-2986
Practice Address - Fax:256-820-8554
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer