Provider Demographics
NPI:1760847867
Name:PASCHKE, PATRICK DAVID
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:DAVID
Last Name:PASCHKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 WHISPERING LN
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-1516
Mailing Address - Country:US
Mailing Address - Phone:715-497-8457
Mailing Address - Fax:
Practice Address - Street 1:505 WHISPERING LN
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-1516
Practice Address - Country:US
Practice Address - Phone:715-497-8457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist