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General NPI Number Information
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NPI Number | 1982629697
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Entity Type | Organization
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Legal Business Name | PATRICK CHIROPRACTIC CENTER, PA
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 415 NE 25TH AVE
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City | OCALA
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State | FL
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Zip | 34470-7037
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Country | US
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Telephone | 352-368-2983
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Fax | 352-368-2984
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Provider Business Mailing Address
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Address Line | 415 NE 25TH AVE
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City | OCALA
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State | FL
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Zip | 34470-7037
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Country | US
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Telephone | 352-368-2983
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Fax | 352-368-2984
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONNA ELAINE PATRICK
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Credential | DC
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Telephone | 352-368-2983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH4799
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License Number State | FL
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