Provider Demographics
NPI:1154524908
Name:PATTERSON CHIROPRACTIC SERVICES C.P.C.
Entity type:Organization
Organization Name:PATTERSON CHIROPRACTIC SERVICES C.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:931-489-5989
Mailing Address - Street 1:130 KEDRON PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174
Mailing Address - Country:US
Mailing Address - Phone:931-489-5989
Mailing Address - Fax:931-489-5991
Practice Address - Street 1:130 KEDRON PARKWAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174
Practice Address - Country:US
Practice Address - Phone:931-489-5989
Practice Address - Fax:931-489-5991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3725801Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
TNU93043Medicare UPIN