Individual
GRANT ROBERT CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1542 GOLF COURSE RD STE 201, GRAND RAPIDS, MN 55744-3537
(218) 326-3433
(218) 326-3435
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
76307
MN
207W00000X
Ophthalmology Physician
MD481576
PA
Other
Enumeration date
04/15/2019
Last updated
01/16/2025
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