Marvin John Grendahl MD a Professional Corp.

NPI #1063694750 in Anchorage, Alaska

Provider Information

NPI Number: 1063694750
Entity Type: Organization
Organization Name: Marvin John Grendahl MD a Professional Corp.
Primary Specialty: Ophthalmology
Enumeration Date: Dec 4, 2007
Last Updated: Nov 22, 2011

Practice Location

Address: 3500 LATOUCHE ST STE 280
City: Anchorage
State: Alaska
ZIP Code: 99508-4261
Phone: (907) 561-1917

Authorized Official

Name: MS. GAIL LEINGANG
Title: OFFICE ADMIN.
Phone: (907) 561-1917

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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