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Individual

MARK S WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1002 N US 27, SAINT JOHNS, MI 48879-1129
(989) 224-3937
(989) 224-4999
Mailing address
1002 N US 27, SAINT JOHNS, MI 48879-1129
(989) 224-3937
(989) 224-4999

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002542
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4294310
MI
Enumeration date
10/20/2005
Last updated
08/11/2011
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