Organization
COUTURE EYEWEAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN BAILEY TRADER NC LICENSED OPTICIAN (OWNER)
(336) 497-5391
Entity
Organization
Contact information
Practice address
1030 S MAIN ST, SUITE P, KERNERSVILLE, NC 27284-7490
(336) 497-5391
(336) 497-4604
Mailing address
1030 S MAIN ST, SUITE P, KERNERSVILLE, NC 27284-7490
(333) 497-5391
(336) 497-4604
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1638
NC
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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