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NPI Code Detail

MEDICARE: DR. JOLENE D PATTERSON DC

MEDICARE: DR. JOLENE D PATTERSON DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2301010593MI

General Provider Information

NPI Number : 1194234336
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOLENE D PATTERSON DC
Provider Business Mailing Address
First Line : 109 LAKE DAVENPORT BLVD
Second Line :
City : DAVENPORT
State : FL
Zip : 33897-9405
Country : US
Telephone Number : 863-256-5030
Fax Number :
Provider Business Practice Location Address
First Line : 4273 NEPTUNE RD
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34769-6744
Country : US
Telephone Number : 248-701-5781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2017
Last Update Date : 08/31/2022

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