Organization
KEVIN C. BERG, O.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN CRAIG BERG O.D. (OWNER)
(907) 376-0835
Entity
Organization
Contact information
Practice address
1350 S SEWARD MERIDIAN PKWY, WASILLA, AK 99654-8332
(907) 376-0835
(907) 376-0843
Mailing address
1350 S SEWARD MERIDIAN PKWY, WASILLA, AK 99654-8332
(907) 376-0835
(907) 376-0843
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
104
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OD1144
—
AK
Enumeration date
02/25/2006
Last updated
03/11/2008
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