Provider Demographics
NPI:1831664796
Name:WHITE, ZACHARY C (DPT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:C
Last Name:WHITE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 GREENLEA BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3205
Mailing Address - Country:US
Mailing Address - Phone:615-339-5096
Mailing Address - Fax:615-657-5855
Practice Address - Street 1:879 GREENLEA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3205
Practice Address - Country:US
Practice Address - Phone:615-339-5096
Practice Address - Fax:615-657-5855
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11840225100000X, 225100000X
FLPT34058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist