Individual
CORWIN WHITWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 S MAIN ST, PLYMOUTH, MI 48170-2089
(877) 248-9321
Mailing address
8201 SYCAMORE CREEK DR, LOUISVILLE, KY 40222-3942
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02748
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A02748
KENTUCKY PTA LICENSE
KY
Enumeration date
02/04/2015
Last updated
02/04/2015
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