Individual
JONATHAN STEVEN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
504 COLLEGE DR, ALBANY, GA 31705-2796
(229) 430-4600
Mailing address
30 MAC ARTHUR DR, GLENS FALLS, NY 12801-2338
(518) 812-5238
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003424
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT003424
ATHLETIC TRAINING
GA
Enumeration date
07/13/2018
Last updated
07/13/2018
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