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Individual

MR. KOREY JALEN WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
55 FRUIT STREET WHITE 1, BOSTON, MA 02241-5005
(617) 724-4100
(617) 726-7415
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(413) 530-5633

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA8972
MA

Other

Enumeration date
09/22/2021
Last updated
09/25/2022
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