Longmont Eyecare, Pllc | |
2285 E Ken Pratt Blvd, Longmont, CO 80504-5223 | |
(720) 652-0455 | |
Not Available |
Full Name | Longmont Eyecare, Pllc |
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Type | Facility |
Speciality | Optometrist |
Location | 2285 E Ken Pratt Blvd, Longmont, Colorado |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104344894 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 0003344 (Colorado) | Primary |
Provider Name | Grace Kim |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760648497 PECOS PAC ID: 8325106834 Enrollment ID: I20171009001597 |
Mailing Address | Practice Location Address |
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Longmont Eyecare, Pllc 2285 E Ken Pratt Blvd, Longmont, CO 80504-5223 Ph: (720) 652-0455 | Longmont Eyecare, Pllc 2285 E Ken Pratt Blvd, Longmont, CO 80504-5223 Ph: (720) 652-0455 |
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