Individual
JUSTIN GRONEWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1804 JACKSON ST, MAPLEWOOD, MN 55117-2325
(612) 655-3410
Mailing address
1804 JACKSON ST, MAPLEWOOD, MN 55117-2325
(612) 655-3410
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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