Provider Demographics
NPI:1346345014
Name:GARRETT, PATRICK (DC, B SCI)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:GARRETT
Suffix:
Gender:M
Credentials:DC, B SCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 EAST 2ND
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-3404
Mailing Address - Country:US
Mailing Address - Phone:316-212-5429
Mailing Address - Fax:888-924-5438
Practice Address - Street 1:224 E 2ND ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3404
Practice Address - Country:US
Practice Address - Phone:316-212-5429
Practice Address - Fax:888-924-5438
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062203OtherBLUE CROSS BLUE SHIELD
KS062203Medicare ID - Type UnspecifiedMEDICARE
KSG86965Medicare UPIN