| NPI | 1427245042 |
|---|---|
| Doing Business As | OPTICAL BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | JENETTE WEAVER Owner 715-732-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |