# WHITEAMIRE CLINIC PA INC

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

## Provider details

- **NPI number:** 1619168614
- **Authorized official:** RUSTY V WHITEAMIRE D.O. (OWNER)
- **Authorized official phone:** (567) 560-3179

## Contact information

- **Practice address:** 2031 PARK AVE W, ONTARIO, OH 44906-2234
- **Practice address phone:** (419) 529-2055
- **Mailing address:** 2031 PARK AVE W, ONTARIO, OH 44906-2234
- **Mailing address phone:** (567) 560-3179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | T47262 | OH | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 01/16/2019