NPI 1003935867
Grand Spectacle INC
Practice location
- Address
- 764 Grand Ave, Saint Paul, MN 55105-3306
- Phone
- (651) 227-8198
- Fax
- (651) 227-8198
Authorised official
- Name
- Matthew McDonough
- Title
- Certified Optician
- Phone
- (651) 227-8198
Registered specialties
Optician
Primary
Registry record
- NPI
- 1003935867
- Entity type
- Organization
- NPI issued
- 29 Mar 2007
- Record last updated
- 22 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.