Individual
NICKLAUS GRONNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
576 APOLLO DR, LINO LAKES, MN 55014-3004
(651) 784-1611
Mailing address
576 APOLLO DR, LINO LAKES, MN 55014-3004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1208
—
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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