Individual
EMILEE JEANNE GRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC, ATC, LAT
Contact information
Practice address
744 MICKELSON TRL, MANKATO, MN 56001-1503
(765) 423-6888
Mailing address
1431 PREMIER DR, MANKATO, MN 56001-6076
(507) 386-6600
(507) 386-0252
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
36001767A
IN
363A00000X
Physician Assistant
Primary
—
MN
Other
Enumeration date
06/27/2014
Last updated
07/10/2019
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