| Organization Name: | BAY EYES SPECTACULAR, INC |
| NPI Number: | 1114046026 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH FRANK GRAVLEE (OWNER) |
| Mailing Address: | 411 N Section St Fairhope |
| State: | AL US |
| Postal Code: | 365322649 |
| Phone Number: | 2519909999 |
| Fax Number: | 2519909990 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 03/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |