Healthcare Provider Details

I. General information

NPI: 1821086430
Provider Name (Legal Business Name): PATRICK T DENNIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 FOREST HILL BLVD SUITE 202
WEST PALM BEACH FL
33406-8902
US

IV. Provider business mailing address

1825 FOREST HILL BLVD SUITE 202
WEST PALM BEACH FL
33406-8902
US

V. Phone/Fax

Practice location:
  • Phone: 561-966-6171
  • Fax: 561-434-4696
Mailing address:
  • Phone: 561-966-6171
  • Fax: 561-434-4696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberCH0006354
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: