Provider Demographics
NPI:1003461104
Name:WHELAN, SCHUYLER MATTHEW (DC)
Entity Type:Individual
Prefix:
First Name:SCHUYLER
Middle Name:MATTHEW
Last Name:WHELAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-4309
Mailing Address - Country:US
Mailing Address - Phone:478-987-9666
Mailing Address - Fax:
Practice Address - Street 1:4027 WATSON BLVD STE 180
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-9544
Practice Address - Country:US
Practice Address - Phone:478-987-9666
Practice Address - Fax:478-988-8091
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor