Provider Demographics
NPI:1972598936
Name:WHITE, CURTIS L (DC)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:L
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 1:122 GATEWAY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-5543
Mailing Address - Country:US
Mailing Address - Phone:704-799-1416
Mailing Address - Fax:704-799-1732
Practice Address - Street 1:122 GATEWAY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5543
Practice Address - Country:US
Practice Address - Phone:704-799-1416
Practice Address - Fax:704-799-1732
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
NC2305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085JAOtherBCBS
NC4511309OtherAETNA - CURTIS WHITE DC
NC89085JAMedicaid
NC7889412OtherAETNA - WHITE CHIROPRACTI
NC2455521Medicare ID - Type UnspecifiedGROUP ID
NC89085JAMedicaid
NC7889412OtherAETNA - WHITE CHIROPRACTI