Provider Demographics
NPI:1780874552
Name:LYNNE UNGER, ODPC
Entity type:Organization
Organization Name:LYNNE UNGER, ODPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:UNGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:616-405-2588
Mailing Address - Street 1:1879 E SHERMAN BLVD
Mailing Address - Street 2:WALMART VISION CENTER
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1858
Mailing Address - Country:US
Mailing Address - Phone:231-739-7124
Mailing Address - Fax:
Practice Address - Street 1:1879 E SHERMAN BLVD
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1858
Practice Address - Country:US
Practice Address - Phone:231-739-7124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty