Individual
CONNIE MARIE GRANDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
134 SOUTHVIEW ST, OWATONNA, MN 55060-3241
(507) 451-1120
(507) 444-6287
Mailing address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
(507) 444-6287
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9651
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767608500
—
MN
Enumeration date
07/21/2006
Last updated
10/28/2008
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