Provider Demographics
NPI:1841334984
Name:WHITE, CHRISTOPHER ANDREW (MS ATC LAT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ANDREW
Last Name:WHITE
Suffix:
Gender:M
Credentials:MS ATC LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-2029
Mailing Address - Country:US
Mailing Address - Phone:602-264-5291
Mailing Address - Fax:
Practice Address - Street 1:4701 N. CENTRAL AVE.
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012
Practice Address - Country:US
Practice Address - Phone:602-264-5291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ01152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer