Individual
BEN D WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
5601 DESOTO AVE., WOODLAND HILLS, CA 91365
(818) 719-2930
Mailing address
393 E WALNUT ST, PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL, PASADENA, CA 91188-0001
(877) 608-0044
(877) 514-0903
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 18603
CA
Other
Enumeration date
04/10/2007
Last updated
12/01/2021
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