Organization
EYEWEAR BOUTIQUE INC
Active
Other names
Randall V Christian
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN S CHRISTIAN (VICE PRESIDENT)
(337) 948-9504
Entity
Organization
Contact information
Practice address
232 N UNION ST, OPELOUSAS, LA 70570-6208
(337) 948-9504
(337) 942-3545
Mailing address
232 N UNION ST, OPELOUSAS, LA 70570-6208
(337) 948-9504
(337) 942-3545
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
793-005T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1178322
—
LA
Enumeration date
02/25/2008
Last updated
04/18/2013
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