| NPI | 1861527251 |
|---|---|
| Former Legal Business Name | SPEC SHOP INC |
| Entity Type | Organization |
| Authorized Contact | MARK HEFFINGTON President 417-882-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2019-12-06 |