# RIVERTOWN OPTICAL SHOP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821326737
- **Authorized official:** PAUL PROUET (OWNER)
- **Authorized official phone:** (504) 782-2990

## Contact information

- **Practice address:** 400 WILLIAMS BLVD, KENNER, LA 70062-7632
- **Practice address phone:** (504) 461-5500
- **Mailing address:** 400 WILLIAMS BLVD, KENNER, LA 70062-7632

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 1274431T | LA | Yes |

## Other

- **Enumeration date:** 12/04/2009
- **Last updated:** 03/17/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2136526 | — | LA |