Provider Demographics
NPI:1619945631
Name:SEXTON, PATRICK JAMES I (ATC, ATR)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JAMES
Last Name:SEXTON
Suffix:I
Gender:M
Credentials:ATC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 FALCON DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6704
Mailing Address - Country:US
Mailing Address - Phone:507-389-2092
Mailing Address - Fax:507-389-5618
Practice Address - Street 1:1400 HIGHLAND CENTER
Practice Address - Street 2:MINNESOTA STATE UNIVERSITY
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001
Practice Address - Country:US
Practice Address - Phone:507-389-2092
Practice Address - Fax:507-389-5618
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer