Individual
RICHARD PAUL GRUNDTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
306 BARCLAY AVE, PINE RIVER, MN 56474-5116
(218) 838-7765
Mailing address
207 28TH AVE SW, BACKUS, MN 56435-2323
(218) 838-7765
(218) 587-2799
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303740
MN
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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