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Organization
WHITTAKER CHIROPRACTIC CENTER, PC
Active
Organization
WHITTAKER CHIROPRACTIC CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLYLE BRET WHITTAKER D.C. (OWNER/CHIROPRACTOR)
(435) 896-5656
Entity
Organization
Contact information
Practice address
458 S MAIN ST, RICHFIELD, UT 84701-2846
(435) 896-5656
(435) 896-2842
Mailing address
458 S MAIN ST, RICHFIELD, UT 84701-2846
(435) 896-5656
(435) 896-2842
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
172697-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000056035
MEDICARE PTAN
—
05
—
528235261019
—
UT
Enumeration date
07/21/2010
Last updated
11/23/2011
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