Individual
MR. DALE A BULTEMEIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
8101 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4163
(260) 969-2418
(260) 432-0493
Mailing address
13328 PLUMBAGO CT, FORT WAYNE, IN 46814-8843
(260) 969-2418
(260) 432-0493
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26014654
IN
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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