Courtney Whitehead, | |
100 Kiowa Dr W Ste 301, Gainesville, TX 76240-9584 | |
(940) 668-8755 | |
Not Available |
Full Name | Courtney Whitehead |
---|---|
Gender | Female |
Speciality | Chiropractor |
Location | 100 Kiowa Dr W Ste 301, Gainesville, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619594413 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 14385 (Texas) | Primary |
Provider Name | Modus Vivendi Chiropractic Pllc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1801106299 PECOS PAC ID: 5092903062 Enrollment ID: O20101217000838 |
Mailing Address | Practice Location Address |
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Courtney Whitehead, 100 Kiowa Dr W Ste 301, Gainesville, TX 76240-9584 Ph: (940) 668-8755 | Courtney Whitehead, 100 Kiowa Dr W Ste 301, Gainesville, TX 76240-9584 Ph: (940) 668-8755 |
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