Organization
RUTH NICOLAS, OD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH NICOLAS OD, PC (PRESIDENT)
(907) 479-4700
Entity
Organization
Contact information
Practice address
570 RIVERSTONE WAY, STE 3, FAIRBANKS, AK 99709-2939
(907) 479-4700
(907) 457-5596
Mailing address
570 RIVERSTONE WAY, STE 3, FAIRBANKS, AK 99709-2939
(907) 479-4700
(907) 457-5596
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
A125
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OD01251
—
AK
Enumeration date
03/18/2008
Last updated
03/18/2008
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