Provider Demographics
NPI:1639290745
Name:PATTERSON, PAUL BERTRAN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:BERTRAN
Last Name:PATTERSON
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:130 KEDRON PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174
Mailing Address - Country:US
Mailing Address - Phone:931-489-5989
Mailing Address - Fax:931-489-5991
Practice Address - Street 1:130 KEDRON PARKWAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174
Practice Address - Country:US
Practice Address - Phone:931-489-5989
Practice Address - Fax:931-489-5991
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor