Healthcare Provider Details

I. General information

NPI: 1114473949
Provider Name (Legal Business Name): HUNTER WHITE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 S WILLIAMS ST
JAMESPORT MO
64648-7187
US

IV. Provider business mailing address

208 S WILLIAMS ST
JAMESPORT MO
64648-7187
US

V. Phone/Fax

Practice location:
  • Phone: 816-752-2479
  • Fax:
Mailing address:
  • Phone: 660-684-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2016030812
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: