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General NPI Number Information
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NPI Number | 1669662037
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Entity Type | Organization
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Legal Business Name | WHALEN CHIROPRACTIC
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 07/31/2007
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Provider Practice Location Address
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Address Line | 24865 5 MILE RD SUITE 3
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City | REDFORD
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State | MI
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Zip | 48239-3694
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Country | US
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Telephone | 313-592-4556
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Fax | 313-592-4556
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Provider Business Mailing Address
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Address Line | 24865 5 MILE RD SUITE 3
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City | REDFORD
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State | MI
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Zip | 48239-3694
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Country | US
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Telephone | 313-592-4556
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Fax | 313-592-4556
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES PATRICK WHALEN
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Credential | DC
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Telephone | 313-592-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2301004806
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License Number State | MI
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