Organization
SPECTACLE SHOP LLC
Active
Other names
The Spectacle Shop LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HAILEY SCHELLING (MANAGER)
(605) 665-9638
Entity
Organization
Contact information
Practice address
415 W 3RD ST, YANKTON, SD 57078-4201
(605) 665-9638
(605) 665-0526
Mailing address
PO BOX 819, 415 W 3RD ST, YANKTON, SD 57078-0819
(605) 665-9638
(605) 665-0526
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100249545-00
—
NE
05
—
9281510
—
SD
Enumeration date
09/29/2005
Last updated
09/19/2023
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