Provider Demographics
NPI:1588831093
Name:WHETTON CHIROPRACTIC, PC
Entity type:Organization
Organization Name:WHETTON CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HELYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHETTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-393-8880
Mailing Address - Street 1:4638 SOUTH 3500 WEST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WEST HAVEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-9439
Mailing Address - Country:US
Mailing Address - Phone:801-393-8880
Mailing Address - Fax:801-393-8881
Practice Address - Street 1:4638 SOUTH 3500 WEST
Practice Address - Street 2:SUITE 6
Practice Address - City:WEST HAVEN
Practice Address - State:UT
Practice Address - Zip Code:84401-9439
Practice Address - Country:US
Practice Address - Phone:801-393-8880
Practice Address - Fax:801-393-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1105651202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD5227Medicaid
UTT04381Medicare UPIN
UT000056003Medicare PIN