| NPI | 1619391836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE G FULLENKAMP O PT Ometrist 513-671-0993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3451/T4444) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2014-02-07 |