Provider Demographics
NPI:1447915723
Name:WHITTLER, CLINTON DALE (DC)
Entity type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:DALE
Last Name:WHITTLER
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 1:7217 CLINTON HWY STE D
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5221
Mailing Address - Country:US
Mailing Address - Phone:865-333-0999
Mailing Address - Fax:
Practice Address - Street 1:7217 CLINTON HWY STE D
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-5221
Practice Address - Country:US
Practice Address - Phone:865-333-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013750111N00000X
TN3554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor