Individual
LARRY JAY GRONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1282 WALNUT ST, DAWSON, MN 56232
(320) 769-7393
(320) 769-2972
Mailing address
1282 WALNUT ST, DAWSON, MN 56232-2333
(320) 769-7393
(320) 769-2972
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39995
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4150236-00
—
MN
Enumeration date
12/11/2006
Last updated
03/18/2022
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