Organization
EYE SHOP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED A SHAVER OD (SOLE MEMBER)
(480) 656-7739
Entity
Organization
Contact information
Practice address
21321 E OCOTILLO RD STE 105, QUEEN CREEK, AZ 85142-5993
(480) 656-7739
(480) 656-1637
Mailing address
21321 E OCOTILLO RD STE 105, QUEEN CREEK, AZ 85142-5993
(480) 656-7739
(480) 656-1637
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1706
AZ
Other
Enumeration date
10/28/2014
Last updated
06/07/2020
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