Individual
MATTHEW GRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1600 UNIVERSITY AVE W # 10, SAINT PAUL, MN 55104-3898
(651) 646-7246
Mailing address
1600 UNIVERSITY AVE W # 10, SAINT PAUL, MN 55104-3898
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
106669
MN
Other
Enumeration date
12/22/2021
Last updated
12/22/2021
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