Individual
MS. MARY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3045 WHITMAN DR., EVERGREEN, CO 80439-2364
(303) 325-5329
(303) 670-3323
Mailing address
27118 MOUNTAIN PARK RD, EVERGREEN, CO 80439
(303) 325-5329
(303) 670-3323
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7572
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7572
PHYSICAL THERAPY LICENSE
CO
Enumeration date
07/08/2005
Last updated
07/21/2022
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