Provider Demographics
NPI:1043422561
Name:WHITE, KATHIE E (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHIE
Middle Name:E
Last Name:WHITE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W CHICAGO STR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036
Mailing Address - Country:US
Mailing Address - Phone:517-278-5567
Mailing Address - Fax:517-278-4437
Practice Address - Street 1:350 W CHICAGO STR
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036
Practice Address - Country:US
Practice Address - Phone:517-278-5567
Practice Address - Fax:517-278-4437
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2008-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI02171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT32647Medicare UPIN
MIOA250060Medicare ID - Type Unspecified