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General NPI Number Information
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NPI Number | 1821301953
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Entity Type | Individual
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Provider Name | SARAH LYNN BUDNICK O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2010
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Last Update Date | 07/18/2010
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Provider Practice Location Address
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Address Line | 1165 SUPERIOR DR
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City | SAINT JOHNS
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State | MI
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Zip | 48879-8234
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Country | US
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Telephone | 989-224-9737
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Fax | 989-224-9739
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Provider Business Mailing Address
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Address Line | 1200 JACKSON DR
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City | OWOSSO
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State | MI
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Zip | 48867-1990
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Country | US
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Telephone | 989-255-0740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4901004587
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License Number State | MI
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