Provider Demographics
NPI:1134641616
Name:SPENCE, KIMBERLY VERA (OD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:VERA
Last Name:SPENCE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:VERA
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:489 BERNARDSTON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1239
Mailing Address - Country:US
Mailing Address - Phone:413-772-2571
Mailing Address - Fax:413-772-2266
Practice Address - Street 1:274 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3992
Practice Address - Country:US
Practice Address - Phone:413-584-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5212152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty