Provider Demographics
NPI:1770617961
Name:ALTEKRUSE, PATRICK MCBRIDE (ATC)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MCBRIDE
Last Name:ALTEKRUSE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9115 LOUIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-588-9115
Mailing Address - Fax:
Practice Address - Street 1:3100 MACOMB ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3324
Practice Address - Country:US
Practice Address - Phone:301-509-7858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer