Provider Demographics
NPI:1639722556
Name:WHITE, ALANA E (LMT)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:E
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 PRIMROSE CT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6004
Mailing Address - Country:US
Mailing Address - Phone:720-526-6281
Mailing Address - Fax:720-204-6378
Practice Address - Street 1:1600 SPECHT POINT RD STE 115
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4311
Practice Address - Country:US
Practice Address - Phone:970-672-5100
Practice Address - Fax:970-672-5105
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0014985225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COMT.0014985OtherCOLORADO DEPT. OF REGULATORY AGENCIES; DIVISION OF PROFESSIONS AND OCCUPATIONS