MEDICARE: DR. PATRICK WILLIAM CASE DC, FACO

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
1	111NX0800X	Orthopedic Chiropractor	08001617A	IN

General Provider Information

NPI Number	:	1487652277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK WILLIAM CASE DC, FACO

Provider Business Mailing Address
First Line	:	3027 MISHAWAKA AVE
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-2347
Country	:	US
Telephone Number	:	574-259-9355
Fax Number	:	574-288-2737

Provider Business Practice Location Address
First Line	:	3027 MISHAWAKA AVE
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-2347
Country	:	US
Telephone Number	:	574-259-9355
Fax Number	:	574-288-2737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/08/2007

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