Organization
COLLEEN PERSONETT, OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLEEN PERSONETT OD (OWNER)
(907) 479-4700
Entity
Organization
Contact information
Practice address
570 RIVERSTONE WAY, SUITE 3, FAIRBANKS, AK 99709-2939
(907) 479-4700
Mailing address
570 RIVERSTONE WAY, SUITE 3, FAIRBANKS, AK 99709-2939
(907) 479-4700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
A192
AK
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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