| NPI | 1023141603 |
|---|---|
| Former Legal Business Name | SPECTACULAR SPECS |
| Entity Type | Organization |
| Authorized Contact | JOE CHADDRICK KEA Owner 662-842-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 578) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2014-04-16 |