St. Charles Vision Outlet Elmwood, LLC

NPI #1114902251 in Jefferson, Louisiana

Provider Information

NPI Number: 1114902251
Entity Type: Organization
Organization Name: St. Charles Vision Outlet Elmwood, LLC
Primary Specialty: Optometrist
Enumeration Date: Dec 13, 2005
Last Updated: Jun 13, 2012

Practice Location

Address: 837 S CLEARVIEW PKWY
City: Jefferson
State: Louisiana
ZIP Code: 70121-3119
Phone: (504) 733-0406

Authorized Official

Name: MRS. JANET DUPLESSIS
Title: INSURANCE ADMINISTRATOR
Phone: (504) 247-9116

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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