MEDICARE: JON A WHALEN D.C.

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	111N00000X	Chiropractor	0104000994	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	068249	OTHER	VA	TRIGON
2	6980050/002	OTHER	VA	CIGNA

General Provider Information

NPI Number	:	1144334681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON A WHALEN D.C.

Provider Business Mailing Address
First Line	:	6420 SEMINOLE TRL
Second Line	:	STE U3
City	:	BARBOURSVILLE
State	:	VA
Zip	:	22923-2836
Country	:	US
Telephone Number	:	434-985-8100
Fax Number	:	434-985-8123

Provider Business Practice Location Address
First Line	:	6420 SEMINOLE TRL
Second Line	:	STE U3
City	:	BARBOURSVILLE
State	:	VA
Zip	:	22923-2836
Country	:	US
Telephone Number	:	434-985-8100
Fax Number	:	434-985-8123

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

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	09/26/2011

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Directions to “ JON A WHALEN D.C.” Practice Location

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