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General NPI Number Information
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NPI Number | 1073043774
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Entity Type | Individual
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Provider Name | ANDREW WHITE
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Gender | Male
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 312 MILLBURY AVE
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City | MILLBURY
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State | MA
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Zip | 01527-3622
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Country | US
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Telephone | 508-793-0088
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Fax |
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Provider Business Mailing Address
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Address Line | 7542 COUNTY ROAD 17
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City | BELFAST
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State | NY
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Zip | 14711-8628
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Country | US
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Telephone | 585-738-6922
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 010886
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | P160839363
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License Number State | WA
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