Individual
MR. WADE ROLLIN CRANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3833 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-2599
(763) 767-3350
(763) 767-0912
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CC00541
MN
Other
Enumeration date
02/28/2013
Last updated
02/07/2019
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