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Organization

THOMAS R WHITTY DC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN M WHITTY (OFFICE MANAGER)
(417) 532-5462
Entity
Organization

Contact information

Practice address
702 OWENS DR, LEBANON, MO 65536-3501
(417) 532-5462
(417) 532-8595
Mailing address
702 OWENS DR, LEBANON, MO 65536-3501
(417) 532-5462
(417) 532-8595

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CE004316
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
752790204
MO
Enumeration date
06/16/2011
Last updated
06/16/2011
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