Individual
MISS KAITLYN MARIE GRELL I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
650 S BREMER AVE, RUSH CITY, MN 55069-9096
(320) 358-4765
Mailing address
50125 ACACIA LN, STANCHFIELD, MN 55080-5176
(612) 987-9158
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1975
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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