Provider Demographics
NPI:1629370234
Name:WHITTEMORE, JOE DAVID II (PT, DPT, SCS)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:DAVID
Last Name:WHITTEMORE
Suffix:II
Gender:M
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4300 WESTBANK DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6547
Mailing Address - Country:US
Mailing Address - Phone:512-306-8071
Mailing Address - Fax:512-306-8518
Practice Address - Street 1:4300 WESTBANK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6547
Practice Address - Country:US
Practice Address - Phone:512-306-8071
Practice Address - Fax:512-306-8518
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1200743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist