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General NPI Number Information
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NPI Number | 1114162310
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Entity Type | Individual
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Provider Name | WHITNEY AYNE WHITTAKER D.P.T., PT
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Gender | Female
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 1000 HERITAGE CIRCLE
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City | ROMNEY
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State | WV
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Zip | 26757-0010
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Country | US
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Telephone | 866-915-1125
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Fax |
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Provider Business Mailing Address
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Address Line | 436 UVILLA ESTATES DR
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City | SHENANDOAH JUNCTION
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State | WV
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Zip | 25442-4619
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Country | US
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Telephone | 304-268-1518
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT002732
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License Number State | WV
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