Provider Demographics
NPI:1821301953
Name:BUDNICK, SARAH LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:LYNN
Last Name:BUDNICK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1990
Mailing Address - Country:US
Mailing Address - Phone:989-255-0740
Mailing Address - Fax:
Practice Address - Street 1:1165 SUPERIOR DR
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-8234
Practice Address - Country:US
Practice Address - Phone:989-224-9737
Practice Address - Fax:989-224-9739
Is Sole Proprietor?:No
Enumeration Date:2010-07-18
Last Update Date:2010-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004587152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist