Doctor Name: | THOMAS JAMES WHITE |
NPI Number: | 1730418120 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 15251 Pleasant Valley Rd Center City, MN - 550129640 |
Business Phone Number: | 6512134787 |
Business Fax Number: | 6512134543 |
Mailing Address: | 15251 Pleasant Valley Rd, CENTER CITY |
State: | MN |
Postal Code: | 550129640 |
Phone Number: | 6512134787 |
Fax Number: | 6512134543 |
NPI Enumeration Date: | 12/14/2009 |
NPI Last Update Date: | 12/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |