Individual
KRISTEN SUZANNE GRACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
955 N MICHIGAN AVE STE 2, GREENSBURG, IN 47240-1487
(812) 222-2020
(855) 515-0832
Mailing address
1900 CHESTER BLVD, RICHMOND, IN 47374-1213
(765) 962-2020
(765) 966-2975
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004374A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18004374A
IN LICENSE
IN
Enumeration date
10/27/2022
Last updated
10/27/2022
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