Provider Demographics
NPI:1518981315
Name:PATRICK, DALE ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:ANDREW
Last Name:PATRICK
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 1:6400 FALLS OF NEUSE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6840
Mailing Address - Country:US
Mailing Address - Phone:919-790-2288
Mailing Address - Fax:919-790-2289
Practice Address - Street 1:6400 FALLS OF NEUSE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6840
Practice Address - Country:US
Practice Address - Phone:919-790-2288
Practice Address - Fax:919-790-2289
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7908382Medicaid
NCT64532Medicare UPIN
NC7908382Medicaid