Individual
MR. ETHAN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
3125 INDEPENDENCE DRIVE, 300B, BIRMINGHAM, AL 35209
(205) 879-7501
(205) 879-0675
Mailing address
3125 INDEPENDENCE DRIVE, 300B, BIRMINGHAM, AL 35209
(205) 879-7501
(205) 879-0675
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH2033
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
418961932
TRICARE
AL
01
—
51094044
BLUE CROSS
AL
01
—
6400002
UNITED HEALTH CARE
AL
Enumeration date
10/02/2006
Last updated
08/28/2013
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