Provider Demographics
NPI:1649820838
Name:PATTI, STEPHEN THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THOMAS
Last Name:PATTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1525
Mailing Address - Country:US
Mailing Address - Phone:704-317-2706
Mailing Address - Fax:
Practice Address - Street 1:2317 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1525
Practice Address - Country:US
Practice Address - Phone:704-317-2706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor