Provider Demographics
NPI:1437468774
Name:SALVO, ELIZA (OD)
Entity type:Individual
Prefix:
First Name:ELIZA
Middle Name:
Last Name:SALVO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 W TUDOR RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-6639
Mailing Address - Country:US
Mailing Address - Phone:907-770-6652
Mailing Address - Fax:907-770-3668
Practice Address - Street 1:341 W TUDOR RD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6639
Practice Address - Country:US
Practice Address - Phone:907-770-6652
Practice Address - Fax:907-770-3668
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.010420152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist