Individual
TORI GROOTWASSINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-3342
(320) 252-3501
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12760
MN
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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