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Individual

DR. LARRY EDWARD WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
787 PEARL ST, BROCKTON, MA 02301-4425
(508) 583-5660
(508) 583-1800
Mailing address
787 PEARL ST., BROCKTON, MA 02301
(508) 583-5660
(508) 583-1800

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
533
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1602985
MA
01
WHY35353
BLUE CROSS
MA
01
Y39454
BLUE CROSS GROUP
MA
Enumeration date
12/20/2006
Last updated
09/27/2013
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