Provider Demographics
NPI:1730415175
Name:HENRY, PATRICIA GRIMMEL (RN, DC)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:GRIMMEL
Last Name:HENRY
Suffix:
Gender:F
Credentials:RN, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 BITTERROOT CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3446
Mailing Address - Country:US
Mailing Address - Phone:720-841-2628
Mailing Address - Fax:
Practice Address - Street 1:2416 BITTERROOT CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3446
Practice Address - Country:US
Practice Address - Phone:720-841-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4363111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist