Provider Demographics
NPI:1619358041
Name:JEANNE NORMAND WHITE, LAC
Entity type:Organization
Organization Name:JEANNE NORMAND WHITE, LAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:N
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:541-482-7056
Mailing Address - Street 1:850 SISKIYOU BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2125
Mailing Address - Country:US
Mailing Address - Phone:541-482-7056
Mailing Address - Fax:541-482-7058
Practice Address - Street 1:850 SISKIYOU BLVD STE 8
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2125
Practice Address - Country:US
Practice Address - Phone:541-482-7056
Practice Address - Fax:541-482-7058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty