Individual
ANGELA ALFRED
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
12 PROFESSIONAL CT, LAFAYETTE, IN 47905-5152
(765) 447-5083
Mailing address
4123 S MICHIGAN ST, SOUTH BEND, IN 46614-2545
(574) 291-8900
(574) 299-8503
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002798
IN
Other
Enumeration date
06/18/2006
Last updated
07/08/2007
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