Provider Demographics
NPI:1740289768
Name:PATERSON, DANIEL JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOHN
Last Name:PATERSON
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 1:6208 LEHMAN DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-8408
Mailing Address - Country:US
Mailing Address - Phone:719-344-8469
Mailing Address - Fax:719-344-8473
Practice Address - Street 1:6208 LEHMAN DR
Practice Address - Street 2:SUITE 225
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-8408
Practice Address - Country:US
Practice Address - Phone:719-344-8469
Practice Address - Fax:719-344-8473
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOAAA0938OtherINDIVIDUAL PTAN
COCOA103738OtherGROUP PTAN
COCOA103738OtherGROUP PTAN
COCOAAA0938OtherINDIVIDUAL PTAN