Provider Demographics
NPI:1265564702
Name:LANDGRAF, PATRICIA HOPE (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:HOPE
Last Name:LANDGRAF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:HOPE
Other - Last Name:GAFFNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:N71W23440 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3279
Mailing Address - Country:US
Mailing Address - Phone:262-510-6706
Mailing Address - Fax:
Practice Address - Street 1:21140 W CAPITOL DR
Practice Address - Street 2:SUITE 1
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53072-2907
Practice Address - Country:US
Practice Address - Phone:262-790-1100
Practice Address - Fax:262-790-1102
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2306-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor