Individual
TERRAN ELIZABETH GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO, MSPO
Contact information
Practice address
1325 N MAIN ST, HARRISON, AR 72601-2212
(479) 418-2297
(479) 227-5439
Mailing address
11766 VALLEYVIEW LN, BENTONVILLE, AR 72712-9330
(870) 307-2174
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OPP00298
AR
224P00000X
Prosthetist
Primary
OPP00298
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
08/17/2022
Last updated
09/14/2023
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