Healthcare Provider Details

I. General information

NPI: 1174889976
Provider Name (Legal Business Name): CHRISTINA K WHITE DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 RUSSELL ST
HADLEY MA
01035-9455
US

IV. Provider business mailing address

43 RUSSELL ST
HADLEY MA
01035-9455
US

V. Phone/Fax

Practice location:
  • Phone: 413-587-3737
  • Fax: 413-587-0037
Mailing address:
  • Phone: 413-587-3737
  • Fax: 413-587-0037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6794
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: