Provider Demographics
NPI:1912565755
Name:HOUSER, PATRICK LEE (BS, DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:LEE
Last Name:HOUSER
Suffix:
Gender:M
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 TYVOLA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-3585
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:624 TYVOLA RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-3585
Practice Address - Country:US
Practice Address - Phone:704-770-8436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4998111NP0017X, 111NX0800X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic