Individual
TERI K. WHITTAKER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2900 HORIZON DR STE 15, BRYANT, AR 72022-9095
(504) 653-2020
(501) 653-7407
Mailing address
11225 HURON LN STE 200A, LITTLE ROCK, AR 72211-1861
(501) 653-2020
(501) 653-7407
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2573
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163095722
—
AR
Enumeration date
08/11/2006
Last updated
06/25/2020
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