Provider Demographics
NPI:1851577480
Name:WHITE, AMANDA M (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:M
Last Name:WHITE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-3409
Mailing Address - Country:US
Mailing Address - Phone:334-356-5571
Mailing Address - Fax:334-730-0971
Practice Address - Street 1:427 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-3409
Practice Address - Country:US
Practice Address - Phone:334-356-5571
Practice Address - Fax:334-730-0971
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27027225200000X
AL2393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant