Healthcare Provider Details

I. General information

NPI: 1467357665
Provider Name (Legal Business Name): GRAND VISION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 6TH STREET
MEEKER CO
81641
US

IV. Provider business mailing address

PO BOX 1008
MEEKER CO
81641-1008
US

V. Phone/Fax

Practice location:
  • Phone: 970-878-5853
  • Fax:
Mailing address:
  • Phone: 970-878-5853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: TREVOR GRANT
Title or Position: OWNER/CEO
Credential: DDS
Phone: 970-623-1775