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General NPI Number Information
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NPI Number | 1235009382
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Entity Type | Organization
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Legal Business Name | SPRING LAKE EYE CARE
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 110 S LAKE AVE STE A
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City | SPRING LAKE
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State | MI
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Zip | 49456-2275
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Country | US
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Telephone | 616-846-5220
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Fax | 616-846-7728
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Provider Business Mailing Address
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Address Line | 1179 WHITEHALL RD STE B
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City | MUSKEGON
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State | MI
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Zip | 49445-2497
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Country | US
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Telephone | 231-750-0842
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Fax | 231-719-9016
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELLE BURKHARDT BULLION
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Credential | OD
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Telephone | 231-750-0842
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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 |
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License Number State |
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