Provider Demographics
NPI:1578981486
Name:JANDL, WHITNEY CHRISTINE (ATC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:CHRISTINE
Last Name:JANDL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 GUNDERSEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650
Mailing Address - Country:US
Mailing Address - Phone:608-775-9423
Mailing Address - Fax:608-775-8614
Practice Address - Street 1:3111 GUNDERSEN DRIVE
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650
Practice Address - Country:US
Practice Address - Phone:608-775-9423
Practice Address - Fax:608-775-8614
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20000102562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer