Healthcare Provider Details

I. General information

NPI: 1205752433
Provider Name (Legal Business Name): TRUE NORTH VISION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 08/09/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2054 30TH AVE
FAIRBANKS AK
99701-7316
US

IV. Provider business mailing address

2054 30TH AVE
FAIRBANKS AK
99701-7316
US

V. Phone/Fax

Practice location:
  • Phone: 907-759-7440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILIP MARC BRUNETTI
Title or Position: SOLE MEMBER / MANAGING MEMBER
Credential: MD
Phone: 907-759-7440