Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 08002444A | IN |
N | 111NP0017X | Pediatric Chiropractor | 4829 | KY |
NPI | 1245309939 |
---|---|
Provider Name | Dr. Rebekah Ann Wittman |
First Address | Richland, IN 47634-9122 |
Second Address | Richland, IN 47634-9480 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 08/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200801450 | (05) | IN |