Individual
CAROL GRETTUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP, CPED
Contact information
Practice address
FARGO VA HEALTHCARE SYSTEM, 2101 ELM STREET N, FARGO, ND 58102
(701) 239-3700
(701) 239-3721
Mailing address
360 32ND AVE W APT 602, WEST FARGO, ND 58078-2947
(701) 261-6601
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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