Individual
COLIN JAMES WHITTIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
452 SE UNIVERSITY AVE, WAUKEE, IA 50263-8121
(515) 987-0465
Mailing address
1404 LINDEN LN, DES MOINES, IA 50315-3347
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000952
IA
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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