Organization
B. JEFFREY PULK, P.C.
Active
Other names
Old Town Optical
Organization subpart
No
Provider details
NPI number
Authorized official
BERNARD JEFFREY PULK O.D. (CEO)
(231) 946-0333
Entity
Organization
Contact information
Practice address
515 S UNION ST, TRAVERSE CITY, MI 49684-3246
(231) 946-0333
(231) 946-1665
Mailing address
515 S UNION ST, TRAVERSE CITY, MI 49684-3246
(231) 946-0333
(231) 946-1665
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004124
MI
152WC0802X
Corneal and Contact Management Optometrist
4901004124
MI
152WS0006X
Sports Vision Optometrist
4901004124
MI
152WV0400X
Vision Therapy Optometrist
4901004124
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4351130
—
MI
Enumeration date
02/22/2008
Last updated
02/22/2008
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