Individual
GINIA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
451 WEST MAIN, COLEMAN, OK 73432
(580) 937-4418
Mailing address
451 W MAIN ST, COLEMAN, OK 73432-0188
(580) 937-4418
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
251300000X
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100684840A
—
OK
05
—
1346424470
—
OK
Enumeration date
09/01/2016
Last updated
09/01/2016
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