| NPI | 1871886176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNELLE G MAYGREN President/O PT Ometrist 907-456-4822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 297) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |