Individual
SLAVA L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1695 LOR RAY DR, NORTH MANKATO, MN 56003-2804
(507) 387-8231
Mailing address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9082
MN
Other
Enumeration date
12/02/2005
Last updated
09/17/2020
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