Healthcare Provider Details

I. General information

NPI: 1598045973
Provider Name (Legal Business Name): PATRICIA PLATTS BRICKEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 POLO RD APT 1211
COLUMBIA SC
29223-8171
US

IV. Provider business mailing address

101 WILDEWOOD PARK DR STE B
COLUMBIA SC
29223-4319
US

V. Phone/Fax

Practice location:
  • Phone: 803-788-7890
  • Fax: 803-250-2581
Mailing address:
  • Phone: 803-788-7890
  • Fax: 803-250-2581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number3399
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: