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General NPI Number Information
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NPI Number | 1316083892
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Entity Type | Organization
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Legal Business Name | WHITBECK CHIROPRACTIC CLINIC P.C.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 4910 E GREENWAY RD SUITE 4
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-1653
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Country | US
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Telephone | 602-867-4800
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Fax | 602-867-7171
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Provider Business Mailing Address
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Address Line | 4910 E GREENWAY RD #4
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-1653
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Country | US
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Telephone | 602-867-4800
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Fax | 602-867-7171
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE LEE WHITBECK
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Credential | D.C.
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Telephone | 602-867-4800
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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 | 4970
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License Number State | AZ
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