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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