Healthcare Provider Details

I. General information

NPI: 1083710412
Provider Name (Legal Business Name): ELIZABETH ANN WHOOLEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. ELIZABETH ANN WHOOLEY KILKENNY

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3592 ALOMA AVENUE SUITE 3
WINTER PARK FL
32792-4012
US

IV. Provider business mailing address

3592 ALOMA AVENUE SUITE 3
WINTER PARK FL
32792-4012
US

V. Phone/Fax

Practice location:
  • Phone: 407-706-1420
  • Fax: 407-673-4534
Mailing address:
  • Phone: 407-706-1420
  • Fax: 407-673-4534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11230
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: