Provider Demographics
NPI:1619681103
Name:WHEELOCK, TED FRANCOIS JR (LMT #5735)
Entity Type:Individual
Prefix:MR
First Name:TED
Middle Name:FRANCOIS
Last Name:WHEELOCK
Suffix:JR
Gender:M
Credentials:LMT #5735
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Mailing Address - Street 1:3400 BIENVILLE ST # A
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5321
Mailing Address - Country:US
Mailing Address - Phone:504-942-9325
Mailing Address - Fax:504-486-0728
Practice Address - Street 1:3400 BIENVILLE ST # A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5321
Practice Address - Country:US
Practice Address - Phone:504-942-9325
Practice Address - Fax:504-486-0728
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA5735225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist