Individual
GREGORY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5775 WAYZATA BLVD STE 140, ST LOUIS PARK, MN 55416-2660
(952) 738-4498
Mailing address
9676 GEISLER RD, EDEN PRAIRIE, MN 55347-3562
(612) 703-5541
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
MN
Other
Enumeration date
04/17/2017
Last updated
04/17/2017
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