Kim, Grace J

Kim, Grace J is an individual health care provider with primary practice located at 2285 E Ken Pratt Blvd , Longmont CO 80504-5223. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kim, Grace J can be contacted via phone (720) 652-0455.

Contact Information

Primary practice address
2285 E Ken Pratt Blvd Longmont CO 80504-5223
Phone: (720) 652-0455
Fax: (303) 532-3269
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 27OA00614700 New Jersey
Eye and Vision Services Providers / Optometrist 152W00000X TUV007342 New York
Eye and Vision Services Providers / Optometrist 152W00000X 0003344 Colorado

Profile Details

NPI number 1760648497
LBN Legal business name Kim, Grace J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2008
Last updated Apr 11th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760648497 NPPES
New Jersey Other 27OA00614700 DOCTOR OF OPTOMETRY
New Jersey Other 27OM00066800 DOCTOR OF OPTOMETRY

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