Individual
MATTIE LYNN STRUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6600 EXCELSIOR BLVD STE 160, ST LOUIS PARK, MN 55426-4713
(952) 993-7705
Mailing address
4212 GRAND AVE, DULUTH, MN 55807-2737
(218) 786-3500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
68230
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2019
Last updated
07/13/2022
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