Healthcare Provider Details

I. General information

NPI: 1962500793
Provider Name (Legal Business Name): CAROL JEANETTE WHITE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SMITH DR STE D2
CRANBERRY TOWNSHIP PA
16066-4130
US

IV. Provider business mailing address

201 SMITH DR STE D2
CRANBERRY TOWNSHIP PA
16066-4130
US

V. Phone/Fax

Practice location:
  • Phone: 724-742-1777
  • Fax: 724-742-1780
Mailing address:
  • Phone: 724-742-1777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009032
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: