Provider Demographics
NPI:1073039483
Name:SPECTRUM EYE CARE LLC
Entity Type:Organization
Organization Name:SPECTRUM EYE CARE LLC
Other - Org Name:BREVIER OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:612-845-7692
Mailing Address - Street 1:143 OAK ST
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-3030
Mailing Address - Country:US
Mailing Address - Phone:952-401-1700
Mailing Address - Fax:
Practice Address - Street 1:143 OAK ST
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331
Practice Address - Country:US
Practice Address - Phone:952-401-1700
Practice Address - Fax:952-401-7908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty