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General NPI Number Information
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NPI Number | 1063103224
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Entity Type | Organization
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Legal Business Name | TUNDRA HEALTH INITIATIVE CORP
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 309 BERING ST #1049
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City | NOME
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State | AK
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Zip | 99762-1049
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Country | US
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Telephone | 907-443-3553
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Fax | 844-901-4313
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Provider Business Mailing Address
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Address Line | 309 BERING ST #1049
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City | NOME
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State | AK
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Zip | 99762-1049
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Country | US
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Telephone | 907-443-3553
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Fax | 844-901-4313
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARCY ONEIL
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Credential | OD
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Telephone | 907-443-3553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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