Organization
21 NORTH KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANA GROVE OD (OWNER)
(773) 663-6882
Entity
Organization
Contact information
Practice address
21 1/2 WASHINGTON ST, VALPARAISO, IN 46383-4778
(219) 286-7007
Mailing address
21 1/2 WASHINGTON ST, VALPARAISO, IN 46383-4778
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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