Most Relevant Information
Provider Data
| NPI Number: | 1003811860 |
| Provider Name: | ROBERT ALAN ROUSH O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 18001875A |
Most Important Dates
| Enumeration Date: | 06/17/2005 |
| Last Updated: | 07/20/2016 |
Provider Practice Location
781 E NORTH STREET
KENDALLVILLE
IN
467551225
Practice Location Phone/Fax
| Phone: | 2603473458 |
| Fax: | 2603474425 |
Provider Mailing Location
781 E NORTH STREET
KENDALLVILLE
IN
467551225
Provider Mailing Phone/Fax
| Phone: | 2603473458 |
| Fax: | 2603474425 |