Charles Derrick Whitaker, DPT

NPI #1407150006 in Jackson, Kentucky

Provider Information

NPI Number: 1407150006
Entity Type: Individual
Name: Charles Derrick Whitaker, DPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Dec 22, 2010
Last Updated: Dec 22, 2010

Practice Location

Address: 695 HIGHWAY 15 N STE 3
City: Jackson
State: Kentucky
ZIP Code: 41339-7005
Phone: (606) 666-9293

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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