Provider Demographics
NPI:1023217668
Name:WHITE, PATTI S (PTA)
Entity Type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:S
Last Name:WHITE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 TURKEY FARM RD
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-8010
Mailing Address - Country:US
Mailing Address - Phone:570-345-6157
Mailing Address - Fax:
Practice Address - Street 1:7 TURKEY FARM RD
Practice Address - Street 2:
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-8010
Practice Address - Country:US
Practice Address - Phone:570-345-6157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant