| NPI | 1225047897 |
|---|---|
| Doing Business As | EYECARE SPECIALTIES/PRIVATE EYES OPTICAL |
| Entity Type | Organization |
| Authorized Contact | JASON STEVEN LAKE Owner 660-747-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO To3409) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |