Individual
LISA CHAUDHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4201 COLDWATER RD, FORT WAYNE, IN 46805-1113
(260) 483-9568
Mailing address
4201 COLDWATER RD, FORT WAYNE, IN 46805-1113
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004199A
IN
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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