Graduated: 2019
NPI: 1669022174
Practice Locations (3)
GRAND ITASCA CLINIC AND HOSPITAL
111 SE 3RD ST
GRAND RAPIDS, MN 557443663
2183263401
GRAND ITASCA CLINIC AND HOSPITAL
1601 GOLF COURSE RD
GRAND RAPIDS, MN 557448648
2183263401
SSM REGIONAL HEALTH SERVICES
114 E S HILLS DR
MARYVILLE, MO 644682659
Source: CMS National Downloadable File, September 2026.