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General NPI Number Information
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NPI Number | 1326187816
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Entity Type | Organization
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Legal Business Name | BAYVIEW CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 104 MIDDESSA DR
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City | MIDDLETOWN
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State | DE
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Zip | 19709-6819
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Country | US
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Telephone | 302-378-2273
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Fax | 302-378-1183
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Provider Business Mailing Address
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Address Line | 104 MIDDESSA DR
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City | MIDDLETOWN
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State | DE
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Zip | 19709-6819
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Country | US
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Telephone | 302-378-2273
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Fax | 302-378-1183
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Authorized Official
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Title or Position | OWNER CHIROPRACTOR
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Name | DR. WELLINGTON SIMMONS WHITLOCK III
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Credential | DC
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Telephone | 302-378-2273
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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 | F10000421
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License Number State | DE
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