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Individual

NATALIE ESILDA MACKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
116 MINNIE ST, FAIRBANKS, AK 99701-3006
(907) 456-7760
(907) 451-7916
Mailing address
116 MINNIE ST, STE A, FAIRBANKS, AK 99701-3006
(503) 804-4909
(907) 451-7916

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
317
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1576235
AK
Enumeration date
11/30/2011
Last updated
03/09/2018
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