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General NPI Number Information
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NPI Number | 1386077592
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Entity Type | Organization
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Legal Business Name | GRACE VISION, INC.
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 3001 WHITE BEAR AVE N SUITE 1050
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City | SAINT PAUL
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State | MN
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Zip | 55109-1215
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Country | US
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Telephone | 651-770-3924
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Fax |
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Provider Business Mailing Address
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Address Line | 3781 FAIRWAY DR
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City | WOODBURY
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State | MN
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Zip | 55125-5019
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Country | US
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Telephone | 651-735-3477
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Fax | 651-770-5316
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEANNY MINGMY LIU-WU
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Credential | O.D.
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Telephone | 651-735-3477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 2339
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License Number State | MN
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