Individual
MR. JESSE WILLIAM WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
75 GLAMORGAN ST, STE. 110, ALLIANCE, OH 44601-2938
(330) 821-2249
(330) 821-9318
Mailing address
75 GLAMORGAN ST, STE. 110, ALLIANCE, OH 44601-2938
(330) 821-2249
(330) 821-9318
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-002099
OH
2255A2300X
Athletic Trainer
AT-000439
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0450355
—
OH
01
—
791650025
R/R MEDICARE PROV #
OH
Enumeration date
07/11/2005
Last updated
06/19/2013
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