Healthcare Provider Details

I. General information

NPI: 1518383454
Provider Name (Legal Business Name): CHRISTOPHER TODD PATTERSON C.O., L.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S PROSTHETICS & SENSORY AIDS SERVICE (3G124)
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

2008 STONEBROOK CIR
MOUNT JULIET TN
37122-4573
US

V. Phone/Fax

Practice location:
  • Phone: 615-873-7770
  • Fax: 615-873-8261
Mailing address:
  • Phone: 615-553-4516
  • Fax: 615-873-8261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number155
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: