Provider Demographics
NPI:1841607991
Name:WHITMAN, DEBORAH JOY (LMT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JOY
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 WEST DR
Mailing Address - Street 2:NONE
Mailing Address - City:CLYDE
Mailing Address - State:MI
Mailing Address - Zip Code:48049-4547
Mailing Address - Country:US
Mailing Address - Phone:810-772-4255
Mailing Address - Fax:
Practice Address - Street 1:3401 WEST DR
Practice Address - Street 2:NONE
Practice Address - City:CLYDE
Practice Address - State:MI
Practice Address - Zip Code:48049-4547
Practice Address - Country:US
Practice Address - Phone:810-772-4255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703090166164W00000X
MI7501003013225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No164W00000XNursing Service ProvidersLicensed Practical Nurse