Individual
MR. CANDELARIO VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DISPENSUNG OPTICIAN
Contact information
Practice address
3500 LATOUCHE ST, SUITE 110, ANCHORAGE, AK 99508-4209
(907) 562-2845
(907) 562-2956
Mailing address
3500 LATOUCHE ST, SUITE 110, ANCHORAGE, AK 99508-4209
(907) 562-2845
(907) 562-2956
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
AA159
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OP1159
—
AK
Enumeration date
02/26/2008
Last updated
02/26/2008
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