BRENT D. BURCH

FORT WAYNE, IN
NPI1033369244
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy152W00000X Optometrist
(Licence: IN  18002685A)
Additional Taxonomies152W00000X Optometrist
(Licence: CO  2358)
Enumeration Date2008-09-24
Last Update Date2012-12-10
Business Address
-- BRENT D. BURCH OD
7625 SOUTHTOWN XING
FORT WAYNE, IN 46816-2517
Phone number: 260-447-9731
Mailing Address
-- BRENT D. BURCH OD
10529 HOSLER RD STE A
LEO, IN 46765-9736
Phone number: 260-627-2669