Healthcare Provider Details

I. General information

NPI: 1366423881
Provider Name (Legal Business Name): PATRICK JOSEPH OKEEFE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 LUISA ST SUITE A
SANTA FE NM
87505-4073
US

IV. Provider business mailing address

1421 LUISA ST SUITE A
SANTA FE NM
87505-4073
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-4225
  • Fax: 505-983-7256
Mailing address:
  • Phone: 505-983-4225
  • Fax: 505-983-7256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1549
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: