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Individual

MRS. TERRI LYNN GRUN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
2524 OAK VIEW RD, MARINETTE, WI 54143-4067
(715) 732-1526
Mailing address
2524 OAK VIEW RD, MARINETTE, WI 54143-4067
(715) 732-1526

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304732-31
WI

Other

Enumeration date
10/04/2012
Last updated
10/04/2012
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