Organization
GRACE MEDICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDI MATTOX (OWNER)
(651) 430-8184
Entity
Organization
Contact information
Practice address
11240 STILLWATER BLVD N, LAKE ELMO, MN 55042-9321
(866) 514-7223
Mailing address
1106 2ND ST N, STILLWATER, MN 55082-4059
(651) 430-8184
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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