Provider Demographics
NPI:1942392394
Name:STUART, PATRICK RELAFORD (DC)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:RELAFORD
Last Name:STUART
Suffix:
Gender:M
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:PO BOX 965
Mailing Address - Street 2:115 S QUINCY STREET
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:KS
Mailing Address - Zip Code:67756-0965
Mailing Address - Country:US
Mailing Address - Phone:785-332-3047
Mailing Address - Fax:785-332-3047
Practice Address - Street 1:115 S QUINCY STREET
Practice Address - Street 2:
Practice Address - City:ST FRANCIS
Practice Address - State:KS
Practice Address - Zip Code:67756-0965
Practice Address - Country:US
Practice Address - Phone:785-332-3047
Practice Address - Fax:785-332-3047
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS5381Medicare UPIN
005381Medicare ID - Type Unspecified