DAVID A. FULLENKAMP,OD, PC

PORTLAND, IN
NPI1235457862
Entity TypeOrganization
Authorized ContactDAVID A. FULLENKAMP
President
260-726-4210
Organization Subpart ?No
Primary Taxonomy332H00000X Eyewear Supplier (Equipment, not the service)
(Licence: IN  18002167A)
Enumeration Date2010-05-06
Last Update Date2010-05-06
Business Address
DAVID A. FULLENKAMP,OD, PC
1111 N MERIDIAN ST
PORTLAND, IN 47371-1024
Phone number: 260-726-4210
Mailing Address
DAVID A. FULLENKAMP,OD, PC
1111 N MERIDIAN ST P.O. BOX 1268
PORTLAND, IN 47371-1024
Phone number: 260-726-4210
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