Individual
CASEY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
491 CARLISLE DR STE A, HERNDON, VA 20170-4895
(703) 869-9601
Mailing address
PO BOX 469, CENTREVILLE, VA 20122-0469
(703) 869-9601
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019009657
VA
Other
Enumeration date
03/05/2015
Last updated
07/04/2019
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