Individual
MICHELLE MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
403 E 1ST ST, SUITE 318 & 319, DIXON, IL 61021-3116
(815) 285-5591
(815) 285-5592
Mailing address
1424 NAN AVE, DIXON, IL 61021-1442
(815) 677-2760
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002122
IL
Other
Enumeration date
05/21/2007
Last updated
02/04/2025
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