Provider Demographics
NPI:1942368659
Name:GRITTA, PATRICIA EILEEN (DC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:EILEEN
Last Name:GRITTA
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 1:1108 HAYS STREET
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301
Mailing Address - Country:US
Mailing Address - Phone:850-222-5362
Mailing Address - Fax:850-222-4369
Practice Address - Street 1:1108 HAYS STREET
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301
Practice Address - Country:US
Practice Address - Phone:850-222-5362
Practice Address - Fax:850-222-4369
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6075111N00000X
GACHIR003104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22417Medicare ID - Type Unspecified
U12703Medicare UPIN