Provider Demographics
NPI:1447304225
Name:WHITTEMORE, TODD ALLAN (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:ALLAN
Last Name:WHITTEMORE
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 1:118 GREAT RD STE 205
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-1190
Mailing Address - Country:US
Mailing Address - Phone:978-897-1770
Mailing Address - Fax:978-897-1715
Practice Address - Street 1:118 GREAT RD
Practice Address - Street 2:SUITE 215
Practice Address - City:STOW
Practice Address - State:MA
Practice Address - Zip Code:01775-1190
Practice Address - Country:US
Practice Address - Phone:978-897-1770
Practice Address - Fax:978-897-1715
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA655790OtherUNITED HEALTHCARE
MA835626OtherMPN
MAY36958OtherBCBS MA INDIVIDUAL
MA1368343002OtherCIGNA HEALTHCARE
MAY39725OtherBCBS MA GROUP
MA3236217OtherAETNA
MA499711OtherTUFTS HEALTHCARE
MA352540OtherHARVARD PILGRIM HEALTHCAR
MA655790OtherUNITED HEALTHCARE
MDY45623Medicare ID - Type UnspecifiedMEDICARE PART B