Organization
NBHT INDIANA
Active
Other names
Vision Boutique, Vision Boutique St John
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEIL ALAN BOLDUS OD (MANAGING MEMBER)
(224) 730-0650
Entity
Organization
Contact information
Practice address
8319 WICKER AVE, SAINT JOHN, IN 46373-8879
(219) 228-1776
(219) 558-0672
Mailing address
8319 WICKER AVE, SAINT JOHN, IN 46373-8879
(219) 228-1776
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/26/2018
Last updated
09/06/2023
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