Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | S01938 | MD |
NPI | 1336218122 |
---|---|
Provider Name | Dr. Patrick Carl Winters |
First Address | La Plata, MD 20646-4961 |
Second Address | La Plata, MD 20646-4961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U70850 | (02) | MD |