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Individual
PROF. MIRANDA WHITE
Active
Individual
PROF. MIRANDA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4564
GA
2251P0200X
Pediatric Physical Therapist
PT004564
GA
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
618882941A
—
GA
Enumeration date
09/22/2006
Last updated
01/30/2020
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