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Organization

EYECARE EXCELLENCE A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DESIREE WHEELER OD (OWNER)
(907) 486-5504
Entity
Organization

Contact information

Practice address
3450 E. REZANOF DR., KODIAK, AK 99615-0827
(907) 486-5504
(907) 486-6577
Mailing address
3450 E REZANOF DR, KODIAK, AK 99615-6953
(907) 486-5504
(907) 486-6577

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
00070
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1031738
AK
Enumeration date
07/20/2005
Last updated
01/13/2021
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