Individual
MR. MATTHEW W WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR L
Contact information
Practice address
800 E 28TH ST, MAIL ROUTE 12210, MINNEAPOLIS, MN 55407-3723
(612) 863-7642
Mailing address
13323 CARAMEL TRL, EDEN PRAIRIE, MN 55346-3240
(952) 906-9387
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101218
MN
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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