Organization
DR LUKE FULLENKAMP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUKE G FULLENKAMP O.D. (OPTOMETRIST)
(513) 671-0993
Entity
Organization
Contact information
Practice address
11711 PRINCETON PIKE, SUITE 941, CINCINNATI, OH 45246-2534
(513) 671-0933
(513) 671-0944
Mailing address
11711 PRINCETON PIKE, SUITE 941, CINCINNATI, OH 45246-2534
(513) 671-0933
(513) 671-0944
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3451/T4444
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0426113
—
OH
Enumeration date
02/07/2014
Last updated
02/07/2014
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