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Organization
RIVERTOWN OPTICAL SHOP
Active
Organization
RIVERTOWN OPTICAL SHOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL PROUET (OWNER)
(504) 782-2990
Entity
Organization
Contact information
Practice address
400 WILLIAMS BLVD, KENNER, LA 70062-7632
(504) 461-5500
Mailing address
400 WILLIAMS BLVD, KENNER, LA 70062-7632
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1274431T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2136526
—
LA
Enumeration date
12/04/2009
Last updated
03/17/2011
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