Individual
JANICE L WHITLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFO
Contact information
Practice address
107 MOSS SPRINGS RD, ALBEMARLE, NC 28001-5140
(704) 983-6770
(704) 983-6160
Mailing address
PO BOX 192, 107 MOSS SPRINGS RD, ALBEMARLE, NC 28002-0192
(704) 983-6770
(704) 983-6160
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
7795213
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5132230001
NPI FOR MEDICARE 1639135536
NC
05
—
7795213
—
NC
Enumeration date
12/28/2010
Last updated
12/28/2010
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