Individual
KRISTABELLE MARIA GRUCHOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3931 LOUISANA AVE S, E400, ST LOUIS PARK, MN 55426
(586) 292-7064
Mailing address
2200 PENNSYLVANIA AVE S, ST LOUIS PARK, MN 55426-2507
(586) 292-7064
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004889
GA
Other
Enumeration date
05/26/2009
Last updated
12/22/2014
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