Individual
JACE GRUGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4227 9TH AVE S, FARGO, ND 58103-2018
(701) 282-6561
Mailing address
4227 9TH AVE S, FARGO, ND 58103-2018
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1887
ND
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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