Individual
ANNELLE GLEE MAYGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
333 COLD STORAGE ROAD, CRAIG, AK 99921
(907) 755-4967
(907) 755-2414
Mailing address
3100 CHANNEL DR STE 300, JUNEAU, AK 99801-7837
(907) 463-4074
(907) 463-1510
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
12333T
CA
152W00000X
Optometrist
2964T
OR
152W00000X
Optometrist
Primary
297
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023212
—
AK
01
—
OPTT297
STATE OF ALASKA
AK
Enumeration date
05/23/2005
Last updated
11/07/2022
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