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General NPI Number Information
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NPI Number | 1447455092
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Entity Type | Organization
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Legal Business Name | WHITE CHIROPRACTIC HEALTH CARE, PLLC
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 1120 CLEAVER RD
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City | CARO
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State | MI
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Zip | 48723-1105
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Country | US
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Telephone | 989-673-4241
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Fax | 989-673-4240
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Provider Business Mailing Address
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Address Line | PO BOX 298 1120 CLEAVER RD
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City | CARO
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State | MI
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Zip | 48723-0298
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Country | US
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Telephone | 989-673-4241
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Fax | 989-673-4240
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MARK OWEN WHITE
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Credential | DC
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Telephone | 989-673-4241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301300303
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License Number State | MI
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