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Individual
DR. LISA MARIE PATT
Active
Individual
DR. LISA MARIE PATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2006033498
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006033498
STATE LICENSE NUMBER
MO
01
—
298105
GHP
MO
01
—
43-1738059
TAX IDENTIFICATION NUMBER
MO
01
—
705076
UHC
MO
01
—
7603897
AETNA
MO
Enumeration date
01/30/2007
Last updated
01/26/2017
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