Provider Demographics
NPI:1437110145
Name:WHITNEY, CHARLES F (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:BOWMAN
Mailing Address - State:ND
Mailing Address - Zip Code:58623-0176
Mailing Address - Country:US
Mailing Address - Phone:701-523-3239
Mailing Address - Fax:701-523-3239
Practice Address - Street 1:111 4TH ST NW
Practice Address - Street 2:
Practice Address - City:BOWMAN
Practice Address - State:ND
Practice Address - Zip Code:58623-4805
Practice Address - Country:US
Practice Address - Phone:701-523-3239
Practice Address - Fax:701-523-3239
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDN4329Medicare ID - Type Unspecified
NDT66836Medicare UPIN