Individual
MR. DOUGLAS E WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT, L/ATC, CSCS
Contact information
Practice address
187 ANDOVER ST, ANDOVER, MA 01810-5638
(978) 658-5556
(978) 658-5269
Mailing address
PO BOX 4053, ANDOVER, MA 01810-0811
(978) 658-5556
(978) 658-5269
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
2255A2300X
Athletic Trainer
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0308943
—
MA
01
—
467531
TUFTS
MA
01
—
Y67383
BC/BS
MA
Enumeration date
07/05/2006
Last updated
03/22/2010
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