Provider Demographics
NPI:1942633193
Name:SMITH, PATRICK WEBSTER (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:WEBSTER
Last Name:SMITH
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 1:1552 NATCHEZ DR
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-2353
Mailing Address - Country:US
Mailing Address - Phone:636-937-7771
Mailing Address - Fax:636-937-7775
Practice Address - Street 1:1552 NATCHEZ DR
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-2353
Practice Address - Country:US
Practice Address - Phone:636-937-7771
Practice Address - Fax:636-937-7775
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014010611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor