Organization
EYEWEAR BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL FLOWERS (OWNER/ OPTICIAN)
(302) 442-3005
Entity
Organization
Contact information
Practice address
1902 MARYLAND AVE, WILMINGTON, DE 19805-4605
(302) 442-3005
Mailing address
1902 MARYLAND AVE, WILMINGTON, DE 19805-4605
(302) 442-3005
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
20170920124
DE
156FC0801X
Contact Lens Fitter
20170920124
DE
332H00000X
Eyewear Supplier
Primary
20170920124
DE
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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