Individual
NICOLE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
377 CLONCE ST, WEBER CITY, VA 24290-7269
(276) 477-5460
Mailing address
377 CLONCE ST, WEBER CITY, VA 24290-7269
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603602
VA
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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