Provider Demographics
NPI:1669435699
Name:O'SHEA, PATRICK B (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:B
Last Name:O'SHEA
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 1:1072 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402
Mailing Address - Country:US
Mailing Address - Phone:419-354-6166
Mailing Address - Fax:419-354-6756
Practice Address - Street 1:1072 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402
Practice Address - Country:US
Practice Address - Phone:419-354-6166
Practice Address - Fax:419-354-6756
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3414316963A12OtherANTHEM
OH341431696-006OtherMEDICAL MUTUAL OF OHIO
OH2022233Medicaid
OH2022233Medicaid
OH3414316963A12OtherANTHEM