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1295811305
SAMUEL RAY SIMMONS
FORT WAYNE, IN
NPI
1295811305
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: IN 18001933A)
Enumeration Date
2006-10-31
Last Update Date
2007-07-09
Business Address
SAMUEL RAY SIMMONS O.D.
3411 N ANTHONY BLVD
FORT WAYNE, IN 46805-2233
Phone number: 260-482-1707
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Mailing Address
SAMUEL RAY SIMMONS O.D.
3411 N ANTHONY BLVD
FORT WAYNE, IN 46805-2233
Phone number: 260-482-1707
Copy
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