Provider Demographics
NPI:1225042260
Name:WHITNER, DAVID KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KEITH
Last Name:WHITNER
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 1:1325 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-3664
Mailing Address - Country:US
Mailing Address - Phone:215-855-5001
Mailing Address - Fax:215-361-9612
Practice Address - Street 1:57 W ORVILLA RD
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-3644
Practice Address - Country:US
Practice Address - Phone:215-855-4700
Practice Address - Fax:215-361-9612
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC00361L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T29371Medicare UPIN
128296PYZMedicare ID - Type Unspecified