Organization
OPTICAL BOUTIQUE ASSOCIATES, LLC
Active
Organization
OPTICAL BOUTIQUE ASSOCIATES, LLC
Active
Other names
Cleveland Eye Optical Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORTNEY MICHELLE WAYCASTER O.D. (OPTOMETRIST/CO-OWNER/MANAGER)
(423) 472-5401
Entity
Organization
Contact information
Practice address
2560 BUSINESS PARK DR NE, CLEVELAND, TN 37311-6503
(423) 472-5401
Mailing address
2560 BUSINESS PARK DR NE, CLEVELAND, TN 37311-6503
(423) 472-5401
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/11/2010
Last updated
06/11/2010
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