Provider Demographics
NPI:1669669677
Name:WHITNEY, DAYLAN JAMES
Entity Type:Individual
Prefix:MR
First Name:DAYLAN
Middle Name:JAMES
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 1:793 W AZURE DR
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322-4945
Mailing Address - Country:US
Mailing Address - Phone:928-301-5917
Mailing Address - Fax:
Practice Address - Street 1:793 W AZURE DR
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-4945
Practice Address - Country:US
Practice Address - Phone:928-301-5917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist