Individual
SCOTT C WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1096 ERIKSON DR, REXBURG, ID 83440-5297
(208) 656-3205
(208) 656-3206
Mailing address
PO BOX 743, REXBURG, ID 83440-0743
(208) 359-8265
(208) 656-3206
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA1111
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010149474
BLUE SHIELD
ID
01
—
C4439
BLUE CROSS
—
05
—
M8070907
—
ID
Enumeration date
07/28/2006
Last updated
11/29/2012
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