MEDICARE: DR. JOHN WILLIAM WHITMIRE 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	1179	OR

General Provider Information

NPI Number	:	1932238771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN WILLIAM WHITMIRE D.C.

Provider Business Mailing Address
First Line	:	1707 LANSING AVE NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-8732
Country	:	US
Telephone Number	:	503-363-3483
Fax Number	:	503-373-3685

Provider Business Practice Location Address
First Line	:	1707 LANSING AVE NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-8732
Country	:	US
Telephone Number	:	503-363-3483
Fax Number	:	503-373-3685

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	08/21/2007

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Directions to “ DR. JOHN WILLIAM WHITMIRE D.C.” Practice Location

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