Provider Demographics
NPI:1447021571
Name:WHITENER, BRYAN SCOTT JR (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:SCOTT
Last Name:WHITENER
Suffix:JR
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 1:911 LAKEVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-6047
Mailing Address - Country:US
Mailing Address - Phone:864-706-4849
Mailing Address - Fax:
Practice Address - Street 1:1315 HAYWOOD RD STE 2
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2266
Practice Address - Country:US
Practice Address - Phone:864-322-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor