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NPI 1013097658

NPI 1013097658 : DWIGHT CARSON WHYNOT DC : JOHNSON CITY, TN

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General NPI Number Information
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    NPI Number           |    1013097658
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    Entity Type          |    Individual 
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    Provider Name        |    DWIGHT CARSON WHYNOT DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/17/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    110 UNIVERSITY PKWY 
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    City                 |    JOHNSON CITY
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    State                |    TN
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    Zip                  |    37604-7334
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    Country              |    US
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    Telephone            |    423-926-9100
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    Fax                  |    423-926-9200
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Provider Business Mailing Address
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    Address Line         |    110 UNIVERSITY PKWY 
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    City                 |    JOHNSON CITY
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    State                |    TN
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    Zip                  |    37604-7334
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    Country              |    US
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    Telephone            |    423-926-9100
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    Fax                  |    423-926-9200
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    1749
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    License Number State |    TN
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