Graduated: 2015
NPI: 1518453554
Practice Locations (3)
2008 KNOLLWOOD DR
Grand Rapids, MN 557444367
204 NW 1ST AVE, SUITE 4
GRAND RAPIDS, MN 557442749
2183925904
PO BOX, SUITE 124
GRAND RAPIDS, MN 55744
Source: CMS National Downloadable File, September 2026.