Provider Demographics
NPI:1366678690
Name:MCWHORTER, JEREMY C (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:C
Last Name:MCWHORTER
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 1:1136 US 31W BYP
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-2420
Mailing Address - Country:US
Mailing Address - Phone:270-843-2255
Mailing Address - Fax:270-782-2822
Practice Address - Street 1:1136 US 31W BYP
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2420
Practice Address - Country:US
Practice Address - Phone:270-843-2255
Practice Address - Fax:270-782-2822
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5186111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor