Individual
BRUCE CARL GRONSETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 RIDGECREST DRIVE SE, ALBUQUERQUE, NM 87108
(505) 265-1711
Mailing address
7508 DEERFIELD RD. NW, ALBUQUERQUE, NM 87120-4530
(505) 899-8331
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2061
NM
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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