Individual
GREGORY D ZIKE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8966 GOULD RD, EDEN PRAIRIE, MN 55347-3326
(605) 610-5648
Mailing address
8966 GOULD RD., EDEN PRAIRIE, MN 55347
(605) 610-5648
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0134
SD
363A00000X
Physician Assistant
1588
IA
Other
Enumeration date
09/29/2008
Last updated
07/31/2013
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