Provider Demographics
NPI:1831664796
Name:WHITE, ZACHARY C (DPT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:C
Last Name:WHITE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 LAKE WORTH RD STE C
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3694
Mailing Address - Country:US
Mailing Address - Phone:561-968-7788
Mailing Address - Fax:561-968-9969
Practice Address - Street 1:3230 LAKE WORTH RD STE C
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461
Practice Address - Country:US
Practice Address - Phone:561-968-7788
Practice Address - Fax:561-968-9969
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32618225100000X
TN11840225100000X
FLPT34058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist