Individual
TRAVIS JARED GRANGRUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, LAT, ATC
Contact information
Practice address
5155 55TH ST NW, ROCHESTER, MN 55901-3855
(507) 535-1977
Mailing address
615 W 5TH ST, ZUMBROTA, MN 55992-1157
(612) 964-5524
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3694
MN
Other
Enumeration date
06/08/2026
Last updated
06/08/2026
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