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NPI Code Detail

MEDICARE: DR. LAQUIRSTA V WHITE DPT

MEDICARE: DR. LAQUIRSTA V WHITE DPT
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 Therapist2305206061VA

General Provider Information

NPI Number : 1609006931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAQUIRSTA V WHITE DPT
Provider Business Mailing Address
First Line : 5388 DISCOVERY PARK BLVD STE 200
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23188-8218
Country : US
Telephone Number : 757-707-3955
Fax Number : 757-603-6231
Provider Business Practice Location Address
First Line : 201 BULIFANTS BLVD STE B
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23188-5731
Country : US
Telephone Number : 757-229-9740
Fax Number : 757-229-9741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2009
Last Update Date : 04/20/2023

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Directions to “ DR. LAQUIRSTA V WHITE DPT” Practice Location

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