Prism Eye Associates LLC

NPI #1194305417 in Ketchikan, Alaska

Provider Information

NPI Number: 1194305417
Entity Type: Organization
Organization Name: Prism Eye Associates LLC
Subpart: Yes (part of a larger organization)
Parent Organization: PRISM EYE ASSOCIATES LLC
Primary Specialty: Optometrist
Enumeration Date: Apr 12, 2021
Last Updated: Aug 30, 2021

Practice Location

Address: 3137 TONGASS AVE STE C
City: Ketchikan
State: Alaska
ZIP Code: 99901-5745
Phone: (907) 885-3999

Authorized Official

Name: DAVID J PEDIGO, OD
Title: MANAGING MEMBER
Phone: (907) 891-7191

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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