Individual
GRACE NIMAT KHOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1230 E. MAIN STREET, MANKATO CLINIC, LTD, MANKATO, MN 56002-8674
(507) 625-1811
(952) 843-4301
Mailing address
PO BOX 8674 1230 E. MAIN STREET, MANKATO CLINIC LTD, MANKATO, MN 56002-8674
(507) 625-1811
(952) 483-4301
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
30851
MN
208D00000X
General Practice Physician
Primary
30851
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
836385400
—
MN
Enumeration date
03/07/2006
Last updated
09/20/2012
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