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General NPI Number Information
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NPI Number | 1972133403
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Entity Type | Individual
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Provider Name | PETER JOHN WHITE L.AC
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Gender | Male
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 4047 N 40TH PL
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City | PHOENIX
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State | AZ
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Zip | 85018-5206
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Country | US
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Telephone | 561-251-2640
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Fax |
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Provider Business Mailing Address
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Address Line | 1034 E LARKSPUR LN
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City | TEMPE
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State | AZ
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Zip | 85281-1621
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Country | US
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Telephone | 561-251-2640
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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