# WHITTAKER CHIROPRACTIC CENTER, PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043523814
- **Authorized official:** CARLYLE BRET WHITTAKER D.C. (OWNER/CHIROPRACTOR)
- **Authorized official phone:** (435) 896-5656

## Contact information

- **Practice address:** 458 S MAIN ST, RICHFIELD, UT 84701-2846
- **Practice address phone:** (435) 896-5656
- **Practice address fax:** (435) 896-2842
- **Mailing address:** 458 S MAIN ST, RICHFIELD, UT 84701-2846
- **Mailing address phone:** (435) 896-5656
- **Mailing address fax:** (435) 896-2842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 172697-1202 | UT | Yes |

## Other

- **Enumeration date:** 07/21/2010
- **Last updated:** 11/23/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000056035 | MEDICARE PTAN | — |
| 05 | — | 528235261019 | — | UT |