Provider Demographics
NPI:1790840155
Name:HEALTH 1ST OF KOKOMO, PC
Entity Type:Organization
Organization Name:HEALTH 1ST OF KOKOMO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:WHITEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:765-864-1877
Mailing Address - Street 1:3807 SOUTHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3638
Mailing Address - Country:US
Mailing Address - Phone:765-864-1877
Mailing Address - Fax:765-864-1889
Practice Address - Street 1:3807 SOUTHLAND AVE
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3638
Practice Address - Country:US
Practice Address - Phone:765-864-1877
Practice Address - Fax:765-864-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002165A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty