Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2660 | OH |
N | 111NS0005X | Chiropractic Sports Physician | 2660 | OH |
NPI | 1013036730 |
---|---|
Provider Name | Dr. Patrick M Prikkel |
First Address | Dayton, OH 45419-1513 |
Second Address | Dayton, OH 45419-1513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |