Organization
MAVENCAMP FAMILY EYECARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL MAVENCAMP O.D. (PRESIDENT)
(907) 479-4700
Entity
Organization
Contact information
Practice address
570 RIVERSTONE WAY, SUITE 3, FAIRBANKS, AK 99709-2939
(907) 479-4700
(907) 457-5596
Mailing address
570 RIVERSTONE WAY, SUITE 3, FAIRBANKS, AK 99709-2939
(907) 479-4700
(907) 457-5596
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
A240
AK
Other
Enumeration date
07/02/2007
Last updated
01/02/2014
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