Provider Demographics
NPI:1891859898
Name:OSTER, PATRICK JACOB (D C)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JACOB
Last Name:OSTER
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1459 COBB PKWY N
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2425
Mailing Address - Country:US
Mailing Address - Phone:770-919-9625
Mailing Address - Fax:770-919-8154
Practice Address - Street 1:1459 COBB PKWY N
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-2425
Practice Address - Country:US
Practice Address - Phone:770-919-9625
Practice Address - Fax:770-919-8154
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor