Healthcare Provider Details

I. General information

NPI: 1235009382
Provider Name (Legal Business Name): SPRING LAKE EYE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S LAKE AVE STE A
SPRING LAKE MI
49456-2275
US

IV. Provider business mailing address

1179 WHITEHALL RD STE B
MUSKEGON MI
49445-2497
US

V. Phone/Fax

Practice location:
  • Phone: 616-846-5220
  • Fax: 616-846-7728
Mailing address:
  • Phone: 231-750-0842
  • Fax: 231-719-9016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELLE BURKHARDT BULLION
Title or Position: OWNER
Credential: OD
Phone: 231-750-0842