Organization
C J PATALUCH OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER PATALUCH OD (PRESIDENT)
(260) 432-8409
Entity
Organization
Contact information
Practice address
6709 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6209
(765) 617-1890
(260) 432-8506
Mailing address
5659 COVENTRY LN, FORT WAYNE, IN 46804-7145
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002539B
IN
Other
Enumeration date
01/10/2011
Last updated
07/26/2022
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