BEN D WHITTAKER

WOODLAND HILLS, CA
NPI1932322096
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  PT 18603)
Enumeration Date2007-04-10
Last Update Date2021-12-01
Business Address
BEN D WHITTAKER RPT
5601 DESOTO AVE.
WOODLAND HILLS, CA 91365
Phone number: 818-719-2930
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