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General NPI Number Information
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NPI Number | 1467565531
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Entity Type | Organization
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Legal Business Name | CLEAR VISION OPTOMETRY, INC
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1867 AIRPORT WAY SUITE 150-A
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City | FAIRBANKS
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State | AK
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Zip | 99701-4007
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Country | US
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Telephone | 907-452-2191
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Fax | 907-452-2618
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Provider Business Mailing Address
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Address Line | 1867 AIRPORT WAY SUITE 150-A
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City | FAIRBANKS
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State | AK
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Zip | 99701-4007
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Country | US
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Telephone | 907-452-2191
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Fax | 907-452-2618
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. BRENDA NABER
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Credential |
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Telephone | 907-452-2024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 312847
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License Number State | AK
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