Provider Demographics
NPI:1477976595
Name:WHITE, BRITTANI (ATC)
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 PATTERSON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1941
Mailing Address - Country:US
Mailing Address - Phone:970-241-5585
Mailing Address - Fax:970-242-1740
Practice Address - Street 1:2646 PATTERSON RD
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1941
Practice Address - Country:US
Practice Address - Phone:970-241-5585
Practice Address - Fax:970-242-1740
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT.00012532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer