Provider Demographics
NPI:1972608859
Name:CARRAHER, PATRICK MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:CARRAHER
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 1:2003 S ALAMOS PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-9425
Mailing Address - Country:US
Mailing Address - Phone:573-875-6739
Mailing Address - Fax:
Practice Address - Street 1:19 E WALNUT ST
Practice Address - Street 2:SUITE F
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4505
Practice Address - Country:US
Practice Address - Phone:573-875-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004671111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor