Individual
JESSICA JUSTICE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LPTA
Contact information
Practice address
9566 KIMBERLY LYNN CIR, GLEN ALLEN, VA 23060-7328
(804) 564-7732
Mailing address
9566 KIMBERLY LYNN CIR, GLEN ALLEN, VA 23060-7328
(804) 564-7732
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001207651
VA
225200000X
Physical Therapy Assistant
Primary
2306001312
VA
Other
Enumeration date
01/28/2013
Last updated
01/28/2013
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