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Individual

DR. LISA MARIE PATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
4800 MEXICO RD STE 101, SAINT PETERS, MO 63376-1666
(314) 690-1525
(636) 246-0446
Mailing address
4800 MEXICO RD STE 101, SAINT PETERS, MO 63376-1666
(314) 690-1525
(636) 246-0446

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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