Provider Demographics
NPI:1073400776
Name:WHITEHEAD, CAMERON J (DC)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:J
Last Name:WHITEHEAD
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 1:210 SW 11TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-5325
Mailing Address - Country:US
Mailing Address - Phone:515-724-0260
Mailing Address - Fax:515-724-0263
Practice Address - Street 1:210 SW 11TH ST STE 3
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-5325
Practice Address - Country:US
Practice Address - Phone:515-724-0260
Practice Address - Fax:515-724-0263
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA133425111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor