MEDICARE: DR. WENDY A WHITLOCK 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	5686	CO

General Provider Information

NPI Number	:	1710988290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY A WHITLOCK D.C.

Provider Business Mailing Address
First Line	:	2532 PATTERSON RD STE 15
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1098
Country	:	US
Telephone Number	:	970-254-2954
Fax Number	:	970-254-2958

Provider Business Practice Location Address
First Line	:	2532 PATTERSON RD STE 15
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1098
Country	:	US
Telephone Number	:	970-254-2954
Fax Number	:	970-254-2958

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	12/17/2007

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