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General NPI Number Information
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NPI Number | 1033294350
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Entity Type | Organization
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Legal Business Name | GUNDERSEN AND ZUKER PLLC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 24 S MICHIGAN AVE
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City | SHELBY
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State | MI
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Zip | 49455-1240
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Country | US
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Telephone | 231-861-5417
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Fax |
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Provider Business Mailing Address
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Address Line | 24 S MICHIGAN AVE
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City | SHELBY
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State | MI
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Zip | 49455-1240
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Country | US
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Telephone | 231-861-5417
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Fax |
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | ELIZABETH FURTAW
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Credential |
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Telephone | 231-722-3556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002694
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License Number State | MI
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