Organization
INLET OPTICAL BOUTIQUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS HANNAN (VICE PRESIDENT OPTICIAN)
(561) 746-5910
Entity
Organization
Contact information
Practice address
103 S US HWY 1, SUITE B2, JUPITER, FL 33477
(561) 746-5910
(561) 746-3268
Mailing address
467 NE 10TH ST, BOCA RATON, FL 33432-2937
(561) 395-2671
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
DO1417
FL
Other
Enumeration date
06/28/2007
Last updated
07/20/2007
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