Diane Elaine White

NPI #1619205614 in Bemidji, Minnesota

Provider Information

NPI Number: 1619205614
Entity Type: Individual
Name: Diane Elaine White
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Enumeration Date: Dec 2, 2009
Last Updated: Dec 2, 2009

Practice Location

Address: 716 PAUL BUNYAN DR NW
City: Bemidji
State: Minnesota
ZIP Code: 56601-2439
Phone: (218) 497-1040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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