Organization
GRACE VISION CARE O.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA J GRACE O.D. (OPTOMETRIST)
(704) 797-1308
Entity
Organization
Contact information
Practice address
403 E STATESVILLE AVE, MOORESVILLE, NC 28115-2675
(704) 797-1308
Mailing address
403 E STATESVILLE AVE, MOORESVILLE, NC 28115-2675
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2193
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5916655
—
NC
Enumeration date
06/26/2014
Last updated
06/26/2014
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