Provider Demographics
NPI:1467791079
Name:WALSH, PATRICK (DC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:WALSH
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 1:19231 OLDE WATERFORD RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-1505
Mailing Address - Country:US
Mailing Address - Phone:248-420-8008
Mailing Address - Fax:
Practice Address - Street 1:13018 PENNSYLVANIA AVE
Practice Address - Street 2:STE 5
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2759
Practice Address - Country:US
Practice Address - Phone:240-347-4360
Practice Address - Fax:240-347-4415
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor