Provider Demographics
NPI:1831376300
Name:WHITE CHIROPRACTIC & WHIPLASH CARE CLINIC
Entity type:Organization
Organization Name:WHITE CHIROPRACTIC & WHIPLASH CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-593-1661
Mailing Address - Street 1:975 N MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2200
Mailing Address - Country:US
Mailing Address - Phone:801-593-1661
Mailing Address - Fax:801-593-5651
Practice Address - Street 1:975 N MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2200
Practice Address - Country:US
Practice Address - Phone:801-593-1661
Practice Address - Fax:801-593-5651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT373236-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty