Individual
KENNETH SHANE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, WCC
Contact information
Practice address
401 MEDICAL PARK DR, ATMORE, AL 36502-3006
(251) 368-6346
(251) 368-6255
Mailing address
817 MEADOWS DR, ATMORE, AL 36502-3306
(251) 368-2726
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3582
AL
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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