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Individual

DR. MARVIN R. ACQUISTAPACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
116 MINNIE ST, FAIRBANKS, AK 99701-3006
(907) 456-7760
(907) 451-7916
Mailing address
750 EASTVIEW DR, FAIRBANKS, AK 99712-2638
(907) 978-2734

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
222
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023203
AK
05
OD0014
AK
Enumeration date
09/13/2006
Last updated
11/03/2017
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