DAVID A. FULLENKAMP, O.D., P.C.

PORTLAND, IN
NPI1346479284
Entity TypeOrganization
Authorized ContactDAVID A. FULLENKAMP
President
260-726-5161
Organization Subpart ?No
Primary Taxonomy152W00000X Optometrist
(Licence: IN  18002167A)
Additional Taxonomies332H00000X Eyewear Supplier (Equipment, not the service)
(Licence: IN  18002167A)
Enumeration Date2009-07-14
Last Update Date2010-05-13
Business Address
DAVID A. FULLENKAMP, O.D., P.C.
1111 N MERIDIAN ST
PORTLAND, IN 47371-1024
Phone number: 260-726-5161
Mailing Address
DAVID A. FULLENKAMP, O.D., P.C.
1111 N MERIDIAN ST P.O. BOX 1268
PORTLAND, IN 47371-1024
Phone number: 260-726-5161