MEDICARE: MR. WHITNEY ATCHETEE P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	00170R	LA

General Provider Information

NPI Number	:	1073517876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WHITNEY ATCHETEE P.T.

Provider Business Mailing Address
First Line	:	317 ODEA ST
Second Line	:
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-4052
Country	:	US
Telephone Number	:	337-893-3258
Fax Number	:	337-898-0495

Provider Business Practice Location Address
First Line	:	317 ODEA ST
Second Line	:
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-4052
Country	:	US
Telephone Number	:	337-893-3258
Fax Number	:	337-898-0495

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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