| Organization Name: | MARVELOUS EYES, LLC |
| NPI Number: | 1104222934 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY P SHAW (PRESIDENT) |
| Mailing Address: | 6723 Deerfoot Pkwy Suite 119 Pinson |
| State: | AL US |
| Postal Code: | 351263011 |
| Phone Number: | 2056833232 |
| Fax Number: | 2056833233 |
| NPI Enumeration Date: | 11/05/2014 |
| NPI Last Update Date: | 11/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |