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NPI Code Detail

MEDICARE: DEREK L. WHITE RPT

MEDICARE: DEREK L. WHITE RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist4252SC

General Provider Information

NPI Number : 1164525630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK L. WHITE RPT
Provider Business Mailing Address
First Line : 800 CRESCENT CENTRE DR STE 300
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-7285
Country : US
Telephone Number : 615-373-1350
Fax Number : 615-221-9054
Provider Business Practice Location Address
First Line : 1602 N HIGHWAY 17
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3310
Country : US
Telephone Number : 843-800-0773
Fax Number : 843-800-0837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2006
Last Update Date : 10/01/2019

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