=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720385263
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LVCTR PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2011
-----------------------------------------------------
Last Update Date | 01/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2900 S COLUMBIA RD
-----------------------------------------------------
City | GRAND FORKS
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58201-6070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-746-6745
-----------------------------------------------------
Fax | 701-746-6961
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2900 S COLUMBIA RD
-----------------------------------------------------
City | GRAND FORKS
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58201-6070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-746-6745
-----------------------------------------------------
Fax | 701-746-6961
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JEFFERY B YUNKER
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 701-746-6745
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------