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General NPI Number Information
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NPI Number | 1982792164
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Entity Type | Individual
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Provider Name | BRENDA J WHITE D.C.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/12/2018
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Provider Practice Location Address
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Address Line | 401 N UNION ST
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City | DODGEVILLE
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State | WI
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Zip | 53533-1347
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Country | US
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Telephone | 608-935-5136
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 N JOHNS ST
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City | DODGEVILLE
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State | WI
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Zip | 53533-1279
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Country | US
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Telephone | 608-935-5136
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3780
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License Number State | WI
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