Provider Demographics
NPI:1447447222
Name:THOMAS & WILLHITE CHIROPRACTIC CLINIC, LTD.
Entity type:Organization
Organization Name:THOMAS & WILLHITE CHIROPRACTIC CLINIC, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:WILLHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC,DABCI
Authorized Official - Phone:920-682-6680
Mailing Address - Street 1:3713 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-5433
Mailing Address - Country:US
Mailing Address - Phone:920-682-6680
Mailing Address - Fax:920-682-6983
Practice Address - Street 1:3713 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-5433
Practice Address - Country:US
Practice Address - Phone:920-682-6680
Practice Address - Fax:920-682-6983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000035574Medicare PIN