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1295727519
KURT W. DOUGHERTY
FORT WAYNE, IN
NPI
1295727519
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: IN 1800214R)
Enumeration Date
2005-08-23
Last Update Date
2008-06-18
Business Address
Dr. KURT W. DOUGHERTY OD
3401 LAKE AVE
FORT WAYNE, IN 46805-5500
Phone number: 260-422-6396
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Mailing Address
Dr. KURT W. DOUGHERTY OD
3401 LAKE AVE
FORT WAYNE, IN 46805-5500
Phone number: 260-422-6396
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