Provider Demographics
NPI:1386278141
Name:PATTERSON, BENNETT W (DC)
Entity type:Individual
Prefix:
First Name:BENNETT
Middle Name:W
Last Name:PATTERSON
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 1:2590 NATURE PARK DR STE 135
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-3187
Mailing Address - Country:US
Mailing Address - Phone:702-636-2843
Mailing Address - Fax:702-726-9543
Practice Address - Street 1:2590 NATURE PARK DR STE 135
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-3187
Practice Address - Country:US
Practice Address - Phone:702-636-2843
Practice Address - Fax:702-726-9543
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor