MEDICARE: UP NORTH EYE CARE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1437890514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UP NORTH EYE CARE, PLLC

Provider Business Mailing Address
First Line	:	224 E CHISHOLM ST STE A
Second Line	:
City	:	ALPENA
State	:	MI
Zip	:	49707-2862
Country	:	US
Telephone Number	:	989-354-5890
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 E CHISHOLM ST STE A
Second Line	:
City	:	ALPENA
State	:	MI
Zip	:	49707-2862
Country	:	US
Telephone Number	:	989-354-5890
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPTOMETRIST
Name	:	DR. LEANN BURNS
Credential	:	OD
Telephone Number	:	989-354-5890

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	04/05/2022

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