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Individual

JONATHAN DANIEL WHITTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BOCO

Contact information

Practice address
103 CLAIR DR STE B, PIEDMONT, SC 29673-6401
(864) 252-4377
Mailing address
315 LOOPER RD, PELZER, SC 29669-1042

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
C52190
SC

Other

Enumeration date
12/31/2018
Last updated
01/23/2023
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Product
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