Provider Demographics
NPI:1518456078
Name:WHITNEY, ERIC EDWIN
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:EDWIN
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4583
Mailing Address - Country:US
Mailing Address - Phone:434-363-6388
Mailing Address - Fax:
Practice Address - Street 1:1180 N INDIAN CANYON DR STE W214
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4857
Practice Address - Country:US
Practice Address - Phone:434-363-6388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program