| Organization Name: | EYE CANDY OPTICAL,LLC |
| NPI Number: | 1275994329 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MELISSA SHAW (OPTICIAN/OWNER) |
| Mailing Address: | 203 S Locust St Suite B Floyd |
| State: | VA US |
| Postal Code: | 240912505 |
| Phone Number: | 5408085123 |
| Fax Number: | |
| NPI Enumeration Date: | 03/17/2016 |
| NPI Last Update Date: | 03/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 1101003815 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |