Provider Demographics
NPI:1629163951
Name:ROWE, PATRICIA SUE (DC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUE
Last Name:ROWE
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 1:3575 RUTHERFORD RD EXT SUITE C
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687
Mailing Address - Country:US
Mailing Address - Phone:864-292-1961
Mailing Address - Fax:
Practice Address - Street 1:3575 RUTHERFORD RD EXT SUITE C
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687
Practice Address - Country:US
Practice Address - Phone:864-292-1961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC813111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T24996Medicare UPIN