Provider Demographics
NPI:1922289255
Name:WHITE, DENISE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:WHITE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18607
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85269-8607
Mailing Address - Country:US
Mailing Address - Phone:480-419-3500
Mailing Address - Fax:480-419-3522
Practice Address - Street 1:10115 E BELL RD
Practice Address - Street 2:SUITE 101B
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2189
Practice Address - Country:US
Practice Address - Phone:480-419-3500
Practice Address - Fax:480-419-3522
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010038292251X0800X
AZ96492251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic