Individual
DR. THU VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1155 SKYLINE DR, CONWAY, AR 72032-2857
(501) 329-2020
Mailing address
7420 PALM BEACH AVE, BENTON, AR 72019-2023
(501) 329-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2587
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167610722
—
AR
Enumeration date
08/09/2007
Last updated
11/17/2023
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