Individual
SUSAN K. GROTHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11200 STILLWATER BLVD N STE 101, LAKE ELMO, MN 55042-8625
(952) 207-4899
Mailing address
10679 83RD ST N, STILLWATER, MN 55082-4515
(952) 207-4899
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
410794
MN
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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