Individual
DR. JASON A WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
333 POST RD W, WESTPORT, CT 06880-4701
(203) 422-0679
(203) 422-0913
Mailing address
35 RIVER RD, COS COB, CT 06807-2759
(203) 422-0679
(203) 422-0913
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14.009619
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080009619CT02
ANTHEM BLUECROSS & BLUESHIELD
CT
05
—
8049282
—
CT
Enumeration date
06/06/2012
Last updated
02/06/2014
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