Healthcare Provider Details

I. General information

NPI: 1396067963
Provider Name (Legal Business Name): ADAM JAMES WHALEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2010
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 DEERWOOD PARK BLVD STE 609A
JACKSONVILLE FL
32256-0596
US

IV. Provider business mailing address

1090 HREZENT VIEW LN
WEBSTER NY
14580-8973
US

V. Phone/Fax

Practice location:
  • Phone: 904-513-3954
  • Fax: 904-212-0223
Mailing address:
  • Phone: 585-750-9615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9918
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: