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1932322096
BEN D WHITTAKER
WOODLAND HILLS, CA
NPI
1932322096
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA PT 18603)
Enumeration Date
2007-04-10
Last Update Date
2021-12-01
Business Address
BEN D WHITTAKER RPT
5601 DESOTO AVE.
WOODLAND HILLS, CA 91365
Phone number: 818-719-2930
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Mailing Address
BEN D WHITTAKER RPT
393 E WALNUT ST PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL
PASADENA, CA 91188-0001
Phone number: 877-608-0044
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