Provider Demographics
NPI:1376062323
Name:WHITTED, DARCI
Entity Type:Individual
Prefix:
First Name:DARCI
Middle Name:
Last Name:WHITTED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DARCI
Other - Middle Name:
Other - Last Name:PEDZINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4020 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-5010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4020 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-5010
Practice Address - Country:US
Practice Address - Phone:765-341-7605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist