Provider Demographics
NPI:1740523042
Name:JEREMY M. WHITFIELD D.C. P.C.
Entity type:Organization
Organization Name:JEREMY M. WHITFIELD D.C. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:MAXWELL
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-727-9543
Mailing Address - Street 1:100 HOPE ST
Mailing Address - Street 2:UNIT 26
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-2507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 HOPE ST
Practice Address - Street 2:UNIT 26
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-2507
Practice Address - Country:US
Practice Address - Phone:203-727-9543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty