Organization
DRS. ROUSH & WILL OPTOMETRISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R ALAN ROUSH O.D. (PRESIDENT)
(260) 347-3611
Entity
Organization
Contact information
Practice address
781 E. NORTH ST, KENDALLVILLE, IN 46755-1225
(260) 347-3611
(260) 347-4425
Mailing address
781 E. NORTH ST, KENDALLVILLE, IN 46755-1225
(260) 347-3611
(260) 347-4425
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
0921390001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100355140A
—
IN
05
—
100355140B
—
IN
05
—
100355140C
—
IN
Enumeration date
01/12/2007
Last updated
07/22/2016
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