Individual
SHANE GRUENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3525 E BATTLEFIELD ST, SPRINGFIELD, MO 65809-3435
(417) 269-1499
Mailing address
6515 S FARM ROAD 189, ROGERSVILLE, MO 65742-8257
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2025004770
MO
Other
Enumeration date
12/19/2024
Last updated
03/11/2025
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