Organization
ST. CHARLES VISION OUTLET MANDEVILLE, LLC
Active
Other names
St. Charles Vision
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTY G ROUSSEL (OFFICE MANAGER)
(985) 626-8103
Entity
Organization
Contact information
Practice address
1844 N. CAUSEWAY BLVD., MANDEVILLE, LA 70471
(985) 626-8103
Mailing address
1844 N. CAUSEWAY BLVD., MANDEVILLE, LA 70471
(985) 626-8103
(985) 626-5571
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1318453T
LA
Other
Enumeration date
03/23/2007
Last updated
06/11/2014
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