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Organization

OPTICAL SHOP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD SPIKER (OPTICIAN)
(636) 937-2399
Entity
Organization

Contact information

Practice address
223 E MAIN ST, FESTUS, MO 63028-1952
(636) 937-2399
(636) 937-4683
Mailing address
223 E MAIN ST, FESTUS, MO 63028-1952
(636) 937-2399
(636) 937-4683

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
12545597
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
321354102
MO
Enumeration date
10/03/2006
Last updated
07/01/2010
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