Provider Demographics
NPI:1467565531
Name:CLEAR VISION OPTOMETRY, INC
Entity Type:Organization
Organization Name:CLEAR VISION OPTOMETRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-452-2024
Mailing Address - Street 1:1867 AIRPORT WAY
Mailing Address - Street 2:SUITE 150-A
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4007
Mailing Address - Country:US
Mailing Address - Phone:907-452-2191
Mailing Address - Fax:907-452-2618
Practice Address - Street 1:1867 AIRPORT WAY
Practice Address - Street 2:SUITE 150-A
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4007
Practice Address - Country:US
Practice Address - Phone:907-452-2191
Practice Address - Fax:907-452-2618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK312847261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center