Provider Demographics
NPI:1700019924
Name:WHITE, VINCENT EUGENE JR (DC)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:EUGENE
Last Name:WHITE
Suffix:JR
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 1:4835 SPARKMAN DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35810-3948
Mailing Address - Country:US
Mailing Address - Phone:256-534-6792
Mailing Address - Fax:256-534-6795
Practice Address - Street 1:4835 SPARKMAN DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-3948
Practice Address - Country:US
Practice Address - Phone:256-534-6792
Practice Address - Fax:256-534-6795
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor