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Individual

ALI GHASSEMI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4201 COLDWATER RD, FORT WAYNE, IN 46805-1113
(260) 484-1816
(260) 484-1816
Mailing address
410 WALLEN HILLS DR APT 5, FORT WAYNE, IN 46825-7028
(260) 403-5099
(260) 484-1816

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003210
IN

Other

Enumeration date
04/02/2007
Last updated
07/08/2007
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