Individual
BROOKE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 WILSON LOOP, WARD, AR 72176
(501) 941-5630
Mailing address
5218 R ST, LITTLE ROCK, AR 72207-4623
(501) 603-9825
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2467
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142647721
—
AR
01
—
5W227
BLUE CROSS BLUE SHEILD
AR
Enumeration date
02/26/2007
Last updated
07/08/2007
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