Individual
MR. JASON GLENN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
59 N WATER ST, ALBION, PA 16401-1214
(814) 756-5616
Mailing address
59 N WATER ST, ALBION, PA 16401-1214
(814) 756-5616
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN283427
PA
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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