Individual
JOHN SHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3450 E. REZANOF DR., KODIAK, AK 99615
(907) 486-5504
Mailing address
PO BOX 827, KODIAK, AK 99615-0827
(907) 486-5504
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0070
AK
Other
Enumeration date
02/28/2007
Last updated
08/23/2007
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