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Individual

MR. JUSTIN PATRICK WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, CSCS, NSCA-CPT

Contact information

Practice address
600 S CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-3966
(386) 226-6527
Mailing address
1096 YORK WAY, PORT ORANGE, FL 32129-4110
(386) 299-5387

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1074
FL

Other

Enumeration date
04/25/2007
Last updated
07/08/2007
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