Provider Demographics
NPI:1992325559
Name:WHITE, HENRIETA JOSEPHINE (DC)
Entity type:Individual
Prefix:DR
First Name:HENRIETA
Middle Name:JOSEPHINE
Last Name:WHITE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 BRINELL ST E APT 310
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3795
Mailing Address - Country:US
Mailing Address - Phone:740-975-1151
Mailing Address - Fax:
Practice Address - Street 1:8311 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-6459
Practice Address - Country:US
Practice Address - Phone:614-888-9355
Practice Address - Fax:614-888-9356
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-04964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor