Individual
MR. JUSTIN FRANCIS WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AM
Contact information
Practice address
1003 PARK ST, OGDENSBURG, NY 13669-3911
(518) 481-1251
Mailing address
275 BALLANTINE RD, HEUVELTON, NY 13654-3303
(315) 854-6975
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
01/05/2022
Last updated
01/17/2022
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