Individual
DR. GRACE J KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2285 E KEN PRATT BLVD, LONGMONT, CO 80504-5223
(720) 652-0455
(303) 532-3269
Mailing address
333 RODDEN DR, ERIE, CO 80516-9104
(848) 219-3891
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0003344
CO
152W00000X
Optometrist
27OA00614700
NJ
152W00000X
Optometrist
TUV007342
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27OA00614700
DOCTOR OF OPTOMETRY
NJ
01
—
27OM00066800
ORAL MEDICATION LICENSE
NJ
Enumeration date
08/01/2008
Last updated
08/07/2024
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