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General NPI Number Information
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NPI Number | 1265709836
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Entity Type | Individual
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Provider Name | ELETREA PATTERSON LMT
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Gender | Female
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Dates
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Enumeration Date | 11/25/2011
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Last Update Date | 11/25/2011
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Provider Practice Location Address
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Address Line | 15233 N 87TH ST SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2646
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Country | US
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Telephone | 480-991-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 4980 S ALMA SCHOOL RD A2190
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City | CHANDLER
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State | AZ
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Zip | 85248-5545
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Country | US
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Telephone | 480-628-5103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-10768
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License Number State | AZ
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