Provider Demographics
NPI:1972804946
Name:GARCIA, PATRICK WAYNE (DC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:WAYNE
Last Name:GARCIA
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 1:1961 MURRAY HOLLADAY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5100
Mailing Address - Country:US
Mailing Address - Phone:801-273-7777
Mailing Address - Fax:801-618-3987
Practice Address - Street 1:1961 MURRAY HOLLADAY RD
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-5100
Practice Address - Country:US
Practice Address - Phone:801-273-7777
Practice Address - Fax:801-618-3987
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7058178-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor