Individual
MR. KHRISTOPHER MICHAEL GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3100 KENNARD ST STE 100, MAPLEWOOD, MN 55109-5466
(651) 232-7800
Mailing address
1809 TRAILWAY DR APT 8, EAGAN, MN 55122-3214
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12403
MN
Other
Enumeration date
06/12/2017
Last updated
03/17/2018
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