DAVID A FULLENKAMP

PORTLAND, IN
NPI1043297625
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy152W00000X Optometrist
(Licence: IN  18002167A)
Enumeration Date2005-12-27
Last Update Date2009-11-24
Business Address
-- DAVID A FULLENKAMP O.D.
1111 N MERIDIAN ST
PORTLAND, IN 47371-1024
Phone number: 260-726-4210
Mailing Address
-- DAVID A FULLENKAMP O.D.
PO BOX 1268
PORTLAND, IN 47371-3268
Phone number: 260-726-4210
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