Healthcare Provider Details

I. General information

NPI: 1154365815
Provider Name (Legal Business Name): LAUREN ELIZABETH SKARNULIS O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN ELIZABETH ZABOWSKI O.D.

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2129 W HOUGHTON LAKE DR
HOUGHTON LAKE MI
48629-8236
US

IV. Provider business mailing address

8154 BEL CHERRIE DR
TRAVERSE CITY MI
49686-1637
US

V. Phone/Fax

Practice location:
  • Phone: 989-366-6344
  • Fax: 989-366-6390
Mailing address:
  • Phone: 231-633-4210
  • Fax: 989-366-6390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberLS004270
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: