| Organization Name: | IMAGE OPTICAL, INC |
| NPI Number: | 1023226362 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICIA HEDGES GAJDOS (PRESIDENT) |
| Mailing Address: | 1867 Airport Way Suite 100 Fairbanks |
| State: | AK US |
| Postal Code: | 997014007 |
| Phone Number: | 9074522024 |
| Fax Number: | 9074524829 |
| NPI Enumeration Date: | 05/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 148 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |