Mavencamp Family Eyecare, INC

NPI #1922205061 in Fairbanks, Alaska

Provider Information

NPI Number: 1922205061
Entity Type: Organization
Organization Name: Mavencamp Family Eyecare, INC
Primary Specialty: Optometrist
Enumeration Date: Jul 2, 2007
Last Updated: Jan 2, 2014

Practice Location

Address: 570 RIVERSTONE WAY
Address 2: SUITE 3
City: Fairbanks
State: Alaska
ZIP Code: 99709-2939
Phone: (907) 479-4700

Authorized Official

Name: DR. MICHAEL MAVENCAMP, O.D.
Title: PRESIDENT
Phone: (907) 479-4700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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