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Individual

DR. KENNETH DAVIS WHIDDEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
501 HARBOR BLVD, SUITE C, DESTIN, FL 32541-2348
(850) 654-1850
(850) 654-9994
Mailing address
501 HARBOR BLVD, SUITE C, DESTIN, FL 32541-2348
(850) 654-1850
(850) 654-9994

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
CH8151
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
381569200
FL
Enumeration date
10/21/2005
Last updated
01/15/2011
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