Provider Demographics
NPI:1821370917
Name:JON A. WHALEN, PC
Entity Type:Organization
Organization Name:JON A. WHALEN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:ANTON
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:434-985-8100
Mailing Address - Street 1:6420 SEMINOLE TRL
Mailing Address - Street 2:STE U3
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22923-2836
Mailing Address - Country:US
Mailing Address - Phone:434-985-8100
Mailing Address - Fax:434-985-8123
Practice Address - Street 1:6420 SEMINOLE TRL
Practice Address - Street 2:STE U3
Practice Address - City:BARBOURSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22923-2836
Practice Address - Country:US
Practice Address - Phone:434-985-8100
Practice Address - Fax:434-985-8123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty