Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 12963 | TX |
NPI | 1285015180 |
---|---|
Provider Name | Dr. Patrick Storey |
First Address | Dallas, TX 75218-1428 |
Second Address | Dallas, TX 75218-1428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 10/12/2015 |