Provider Demographics
NPI:1437468352
Name:WHITMORE, GARRETT W (OD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:W
Last Name:WHITMORE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1242
Mailing Address - Country:US
Mailing Address - Phone:989-463-1139
Mailing Address - Fax:989-466-2808
Practice Address - Street 1:1321 PINE AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1242
Practice Address - Country:US
Practice Address - Phone:989-463-1139
Practice Address - Fax:989-466-2808
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004611152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist