Individual
JOHANNA LEIGH WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LAT, ATC
Contact information
Practice address
12420 BAILEY RD, CORNELIUS, NC 28031-9134
(980) 344-0514
Mailing address
1100 SOUTH BLVD APT 566, CHARLOTTE, NC 28203-6534
(910) 233-2547
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-2925
NC
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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