Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR010217 | GA |
NPI | 1003461104 |
---|---|
Provider Name | Schuyler Matthew Whelan |
First Address | Perry, GA 31069-4309 |
Second Address | Warner Robins, GA 31093-9544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2019 |
Last Update Date | 06/08/2019 |