Provider Demographics
NPI:1962451641
Name:WHITMAN, JENNIFER L (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-8946
Mailing Address - Country:US
Mailing Address - Phone:517-668-0411
Mailing Address - Fax:517-669-5121
Practice Address - Street 1:109 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-8946
Practice Address - Country:US
Practice Address - Phone:517-668-0411
Practice Address - Fax:517-669-5121
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU76324Medicare UPIN
MI0M85710Medicare ID - Type Unspecified