Healthcare Provider Details

I. General information

NPI: 1134641616
Provider Name (Legal Business Name): KIMBERLY VERA SPENCE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY VERA KNIGHT

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 PLEASANT ST
NORTHAMPTON MA
01060-3992
US

IV. Provider business mailing address

489 BERNARDSTON RD STE 202
GREENFIELD MA
01301-1239
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-6616
  • Fax:
Mailing address:
  • Phone: 413-772-2571
  • Fax: 413-772-2266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5212
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: