Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 08002165A | IN |
NPI | 1003874272 |
---|---|
Provider Name | Dr. Christopher Keith Whiteman |
First Address | Kokomo, IN 46901-3612 |
Second Address | Muncie, IN 47304-5472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 20/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V04345 | (02) | IN |