Provider Demographics
NPI:1396249603
Name:WITTER, JOSHUA (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:WITTER
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 1:19 ELMWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7139
Mailing Address - Country:US
Mailing Address - Phone:870-540-7170
Mailing Address - Fax:
Practice Address - Street 1:1100 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-2041
Practice Address - Country:US
Practice Address - Phone:501-371-0022
Practice Address - Fax:501-371-0810
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15988111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic