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NPI 1790185338

NPI 1790185338 : DAVID WHITELOCK ATR, ATC : HIGHLANDS RANCH, CO

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General NPI Number Information
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    NPI Number           |    1790185338
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID WHITELOCK ATR, ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/02/2014
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    Last Update Date     |    09/02/2014
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Provider Practice Location Address
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    Address Line         |    2587 COVE CREEK CT 
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    City                 |    HIGHLANDS RANCH
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    State                |    CO
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    Zip                  |    80129-6463
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    Country              |    US
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    Telephone            |    303-807-2137
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2587 COVE CREEK CT 
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    City                 |    HIGHLANDS RANCH
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    State                |    CO
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    Zip                  |    80129-6463
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    Country              |    US
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    Telephone            |    303-807-2137
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    AT.0000534
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    License Number State |    CO
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