Organization
VISION BOUTIQUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY LEE MORTON (OWNER,MANAGER,LICENSED OPTICIAN)
(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
332BC3200X
Customized Equipment (DME)
Primary
0528
NC
Other
Enumeration date
01/24/2007
Last updated
08/22/2020
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