Provider Demographics
NPI:1891820379
Name:WHITE, RORY (DC)
Entity Type:Individual
Prefix:DR
First Name:RORY
Middle Name:
Last Name:WHITE
Suffix:
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 1:811 GRAND CAILLOU RD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70363-5885
Mailing Address - Country:US
Mailing Address - Phone:985-873-7721
Mailing Address - Fax:
Practice Address - Street 1:811 GRAND CAILLOU RD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70363-5885
Practice Address - Country:US
Practice Address - Phone:985-873-7721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1149111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1544469Medicaid
IA1544469Medicaid