Provider Demographics
NPI:1831358704
Name:WHITE, CAROLYN A (PT)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:A
Last Name:WHITE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:276 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8337
Mailing Address - Country:US
Mailing Address - Phone:617-417-7177
Mailing Address - Fax:
Practice Address - Street 1:22 MILL STREET
Practice Address - Street 2:SUITE 406
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476
Practice Address - Country:US
Practice Address - Phone:781-646-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist