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Individual

EMILY WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
19 LEXIS CT, BLOOMINGTON, IL 61704-4814
(309) 824-7297
Mailing address
19 LEXIS CT, BLOOMINGTON, IL 61704-4814
(309) 824-7297

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012100A
IN
225100000X
Physical Therapist
PT-4534
ID

Other

Enumeration date
10/01/2016
Last updated
10/01/2016
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