Provider Demographics
NPI:1124234190
Name:PATTERSON, LAURA JEAN (DC)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JEAN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3118 BLUEBELL AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1778
Mailing Address - Country:US
Mailing Address - Phone:612-242-1204
Mailing Address - Fax:
Practice Address - Street 1:3118 BLUEBELL AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1778
Practice Address - Country:US
Practice Address - Phone:612-242-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor