Organization
VISION BOUTIQUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY L MORTON OPTICIAN (OWNER)
(704) 482-9883
Entity
Organization
Contact information
Practice address
212 W DIXON BLVD, SHELBY, NC 28152-6522
(704) 482-9883
(704) 482-9842
Mailing address
212 W DIXON BLVD, SHELBY, NC 28152-6522
(704) 482-9883
(704) 482-9842
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
200001385282
NC
Other
Enumeration date
03/21/2007
Last updated
03/25/2008
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