Provider Demographics
NPI:1568471613
Name:WHITE-MANESS, BETH ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:WHITE-MANESS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:WHITE-MANESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPT
Mailing Address - Street 1:2023 RT 88 E
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724
Mailing Address - Country:US
Mailing Address - Phone:732-458-5885
Mailing Address - Fax:732-458-6488
Practice Address - Street 1:2023 RT 88 E
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724
Practice Address - Country:US
Practice Address - Phone:732-458-5885
Practice Address - Fax:732-458-6488
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ553105Medicare PIN