Individual
AVERY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
811 W SAINT JOHNS AVE, UNIT 2105, AUSTIN, TX 78752-2387
(512) 850-7148
Mailing address
PO BOX 203894, AUSTIN, TX 78720-3894
(512) 850-7148
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT104847
TX
Other
Enumeration date
09/01/2011
Last updated
05/15/2015
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