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Individual

DR. JONATHAN JAY GRUSSING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
23 NORTH MAIN STREET, CLARA CITY, MN 56222-0793
(320) 847-3511
(320) 847-3752
Mailing address
23 NORTH MAIN STREET, P.O. BOX 793, CLARA CITY, MN 56222-0793
(320) 847-3511
(320) 847-3752

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3280
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
128M9HE
BCBS GROUP ID NUMBER
MN
01
129MOGR
BCBS INDIVIDUAL ID
MN
Enumeration date
02/21/2007
Last updated
07/09/2007
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