Provider Demographics
NPI:1023340460
Name:PATTEN, PATRICK PHILLUP (LAC, DIPL AC, LMT)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:PHILLUP
Last Name:PATTEN
Suffix:
Gender:M
Credentials:LAC, DIPL AC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3628 E MARMORA ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7376
Mailing Address - Country:US
Mailing Address - Phone:602-999-8323
Mailing Address - Fax:
Practice Address - Street 1:1355 S HIGLEY RD
Practice Address - Street 2:#111
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4799
Practice Address - Country:US
Practice Address - Phone:480-773-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist