Provider Demographics
NPI:1790185338
Name:WHITELOCK, DAVID (ATR, ATC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:WHITELOCK
Suffix:
Gender:M
Credentials:ATR, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2587 COVE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6463
Mailing Address - Country:US
Mailing Address - Phone:303-807-2137
Mailing Address - Fax:
Practice Address - Street 1:2587 COVE CREEK CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-6463
Practice Address - Country:US
Practice Address - Phone:303-807-2137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT.00005342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer