Individual
GARRET FITZSIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(952) 967-7616
(952) 883-9676
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
13659
MN
363A00000X
Physician Assistant
Primary
57466
CA
363AM0700X
Medical Physician Assistant
57466
CA
Other
Enumeration date
02/11/2020
Last updated
08/20/2021
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