Provider Demographics
NPI:1942827100
Name:CHENOWETH, PATRICK CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:CHRISTOPHER
Last Name:CHENOWETH
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 1:630 GREEN ACRES LN
Mailing Address - Street 2:
Mailing Address - City:BOSQUE FARMS
Mailing Address - State:NM
Mailing Address - Zip Code:87068-9006
Mailing Address - Country:US
Mailing Address - Phone:505-220-4800
Mailing Address - Fax:
Practice Address - Street 1:7007 WYOMING BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3987
Practice Address - Country:US
Practice Address - Phone:505-299-2225
Practice Address - Fax:505-822-0316
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDC2241111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor