Individual
COREY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1190 N STATE ST, PT DEPARTMENT, JACKSON, MS 39202-2413
(601) 968-1148
(601) 968-1337
Mailing address
1190 N STATE ST, PT DEPARTMENT, JACKSON, MS 39202-2413
(601) 968-1148
(601) 968-1337
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4900
MS
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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