Individual
ALLISON MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2121 LAKE AVE, EYE CLINIC 112B, FORT WAYNE, IN 46805-5100
(260) 460-1442
Mailing address
2121 LAKE AVE, EYE CLINIC 112B, FORT WAYNE, IN 46805-5100
(260) 460-1442
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004846
MI
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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