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General NPI Number Information
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NPI Number | 1942077243
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Entity Type | Organization
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Legal Business Name | VISION CENTERS OF ALASKA, INC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 3137 TONGASS AVE STE C
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City | KETCHIKAN
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State | AK
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Zip | 99901-5745
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Country | US
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Telephone | 907-444-1850
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Fax |
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Provider Business Mailing Address
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Address Line | 3137 TONGASS AVE STE C
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City | KETCHIKAN
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State | AK
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Zip | 99901-5745
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Country | US
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Telephone | 907-444-1850
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Fax | 907-444-1850
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Authorized Official
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Title or Position | DIRECTOR OF OPTOMETRIC SERVICES
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Name | DAVID PEDIGO
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Credential | OD
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Telephone | 907-444-1850
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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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