Provider Demographics
NPI:1821287137
Name:PERRY, WHITE-EAGLE (LAC, DIPL AC)
Entity Type:Individual
Prefix:MR
First Name:WHITE-EAGLE
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:LAC, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4709 W 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-4009
Mailing Address - Country:US
Mailing Address - Phone:303-885-9464
Mailing Address - Fax:
Practice Address - Street 1:4709 W 52ND AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-4009
Practice Address - Country:US
Practice Address - Phone:303-885-9464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1260171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist