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General NPI Number Information
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NPI Number | 1922279777
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Entity Type | Organization
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Legal Business Name | SPECTACULAR VISION SERVICES
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 3433 BUCKHORN DR
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City | NORMAN
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State | OK
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Zip | 73072-2983
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Country | US
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Telephone | 405-360-2949
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Fax | 405-360-8650
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Provider Business Mailing Address
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Address Line | 3433 BUCKHORN DR
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City | NORMAN
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State | OK
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Zip | 73072-2983
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Country | US
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Telephone | 405-360-2949
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Fax | 405-360-8650
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Authorized Official
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Title or Position | OWNER
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Name | MRS. URSULA YVONNE CARTER
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Credential |
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Telephone | 405-360-2949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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