Provider Demographics
NPI:1437518958
Name:PATTON, ERICA (DC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:PATTON
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 1:18112 DAWNS TRL
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-8434
Mailing Address - Country:US
Mailing Address - Phone:620-404-9453
Mailing Address - Fax:
Practice Address - Street 1:3828 S LINDBERGH BLVD STE 116
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1366
Practice Address - Country:US
Practice Address - Phone:314-485-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016002162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor