Provider Demographics
NPI:1710311469
Name:WHITLOW, JOHN BLANTON (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BLANTON
Last Name:WHITLOW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 OLD DOMINION DR
Mailing Address - Street 2:#102
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3420
Mailing Address - Country:US
Mailing Address - Phone:703-528-8883
Mailing Address - Fax:703-528-8884
Practice Address - Street 1:4625 OLD DOMINION DR
Practice Address - Street 2:#102
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-3420
Practice Address - Country:US
Practice Address - Phone:703-528-8883
Practice Address - Fax:703-528-8884
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor