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General NPI Number Information
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NPI Number | 1205018223
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Entity Type | Organization
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Legal Business Name | KATRINA VAN PATTEN, O.D. LTD.
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 410 FLEISCHMANN WAY
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City | CARSON CITY
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State | NV
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Zip | 89703-2984
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Country | US
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Telephone | 775-882-3977
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Fax | 775-882-3285
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Provider Business Mailing Address
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Address Line | 410 FLEISCHMANN WAY
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City | CARSON CITY
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State | NV
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Zip | 89703-2984
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Country | US
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Telephone | 775-882-3977
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Fax | 775-882-3285
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATRINA VAN PATTEN
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Credential | O.D.
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Telephone | 775-882-3977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | NV200
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License Number State | NV
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