Colleen Personett, Od, Llc | |
570 Riverstone Way, Suite 3, Fairbanks, AK 99709-2939 | |
(907) 479-4700 | |
Not Available |
Full Name | Colleen Personett, Od, Llc |
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Type | Facility |
Speciality | Optometrist |
Location | 570 Riverstone Way, Fairbanks, Alaska |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588800817 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | A192 (Alaska) | Primary |
Provider Name | Colleen Personett |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1295894103 PECOS PAC ID: 7012930001 Enrollment ID: I20060105000037 |
Mailing Address | Practice Location Address |
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Colleen Personett, Od, Llc 570 Riverstone Way, Suite 3, Fairbanks, AK 99709-2939 Ph: (907) 479-4700 | Colleen Personett, Od, Llc 570 Riverstone Way, Suite 3, Fairbanks, AK 99709-2939 Ph: (907) 479-4700 |
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