Provider Demographics
NPI:1437407608
Name:WHITE, EVAN SUTHERLAND (DC)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:SUTHERLAND
Last Name:WHITE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-4958
Mailing Address - Country:US
Mailing Address - Phone:303-515-0591
Mailing Address - Fax:
Practice Address - Street 1:401 S 8TH ST
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4958
Practice Address - Country:US
Practice Address - Phone:303-515-0591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006894111N00000X
AL2496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor