Provider Demographics
NPI:1508984592
Name:GLOVER, PATRICK A JR (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:A
Last Name:GLOVER
Suffix:JR
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 1:3750 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2039
Mailing Address - Country:US
Mailing Address - Phone:814-833-9399
Mailing Address - Fax:814-836-2963
Practice Address - Street 1:3750 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2039
Practice Address - Country:US
Practice Address - Phone:814-833-9399
Practice Address - Fax:814-836-2963
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007576L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA410491OtherUPMC PROVIDER NUMBER
PAGL053927OtherHIGHMARK BC BS
PAU78461Medicare UPIN
PAGL053927OtherHIGHMARK BC BS