Provider Demographics
NPI:1962852921
Name:VAINIO, LINDSAY MICHAEL (OD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MICHAEL
Last Name:VAINIO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2259
Mailing Address - Country:US
Mailing Address - Phone:406-563-6471
Mailing Address - Fax:406-563-7252
Practice Address - Street 1:100 W PARK AVE
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2259
Practice Address - Country:US
Practice Address - Phone:406-563-6471
Practice Address - Fax:406-563-7252
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2689152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist