Provider Demographics
NPI:1700072881
Name:PATRICK D LAYTON JR DC PLLC
Entity Type:Organization
Organization Name:PATRICK D LAYTON JR DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:239-777-5553
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34146-0202
Mailing Address - Country:US
Mailing Address - Phone:239-777-5553
Mailing Address - Fax:
Practice Address - Street 1:3893 MANNIX DR
Practice Address - Street 2:#517
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-5416
Practice Address - Country:US
Practice Address - Phone:239-777-5553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty