Individual
IRENE GRUDSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10550 WAYZATA BLVD, MINNETONKA, MN 55305
(763) 694-0222
Mailing address
6384 SHADYVIEW LANE NORTH, MAPLE GROVE, MN 55311
(763) 222-8051
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1075653
MN
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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