Organization
VICTORIAN EYES
Active
Other names
OPTICAL BOUTIQUE
Organization subpart
No
Provider details
NPI number
Authorized official
JENETTE WEAVER (OWNER)
(715) 732-2007
Entity
Organization
Contact information
Practice address
1400 UNIVERSITY DR STE 102, MARINETTE, WI 54143-5106
(715) 732-2007
(715) 732-0936
Mailing address
1400 UNIVERSITY DR STE 102, MARINETTE, WI 54143-5106
(715) 732-2007
(715) 732-0936
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38455000
—
WI
Enumeration date
09/27/2007
Last updated
09/27/2007
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