Individual
CHARLES THOMAS WITHERELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
974 OLD DIXIE HWY, HOMESTEAD, FL 33030-4933
(305) 247-7300
(305) 248-0513
Mailing address
97 NE 15TH ST, HOMESTEAD, FL 33030-4557
(305) 247-7300
(305) 248-0513
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2061
NC
111N00000X
Chiropractor
Primary
CH6625
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381-778-400
—
FL
Enumeration date
05/01/2006
Last updated
11/23/2021
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