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Individual

TIMOTHY GREVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.T.C., P.E.S.

Contact information

Practice address
275 SYNDICATE ST N, SAINT PAUL, MN 55104-5436
(651) 641-8230
Mailing address
3929 LYNDALE AVE S, MINNEAPOLIS, MN 55409-1464

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2173
MN

Other

Enumeration date
11/01/2011
Last updated
11/01/2011
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