Individual
MR. GARY R COMFORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
Mailing address
16671 300TH ST, NEW PRAGUE, MN 56071-4435
(952) 758-5018
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 119441-0
MN
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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