Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 80104201202 | UT |
NPI | 1063709707 |
---|---|
Provider Name | Dr. Christopher Orrin Whetton |
First Address | West Haven, UT 84401-6506 |
Second Address | West Haven, UT 84401-6506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 01/07/2011 |