Provider Demographics
NPI:1881765568
Name:KADRMAS, PATRICK DONALD (DC)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:DONALD
Last Name:KADRMAS
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 1:16 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59645-9036
Mailing Address - Country:US
Mailing Address - Phone:928-771-8162
Mailing Address - Fax:
Practice Address - Street 1:142 N RUSH STREET
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301
Practice Address - Country:US
Practice Address - Phone:928-771-8162
Practice Address - Fax:928-717-2757
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDC5017111N00000X
MTCHI-CHI-LIC-5039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0930080OtherBCBS
AZDC5017Medicare ID - Type Unspecified
AZ0930080OtherBCBS