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General NPI Number Information
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NPI Number | 1245331438
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Entity Type | Organization
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Legal Business Name | KENAI VISION CENTER
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 110 S WILLOW ST STE 108
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City | KENAI
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State | AK
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Zip | 99611-7798
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Country | US
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Telephone | 907-283-7575
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Fax | 907-283-6156
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Provider Business Mailing Address
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Address Line | 110 S WILLOW ST STE 108
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City | KENAI
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State | AK
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Zip | 99611-7798
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Country | US
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Telephone | 907-283-7575
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Fax | 907-283-6156
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | DR. DENNIS A SWARNER
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Credential | OD
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Telephone | 907-283-7575
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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 | 63959
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License Number State | AK
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