Organization
DR TABITHA G TEMPLE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TABITHA G. TEMPLE O.D. (OWNER PRESIDENT)
(574) 267-3515
Entity
Organization
Contact information
Practice address
3505 N STATE ROAD 15, SUITE B, WARSAW, IN 46582-5503
(574) 267-3515
(574) 267-3259
Mailing address
3505 N STATE ROAD 15, SUITE B, WARSAW, IN 46582-5503
(574) 267-3515
(574) 267-3259
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002882
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200388760A
—
IN
Enumeration date
10/01/2006
Last updated
07/03/2008
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