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1003057118
GRAYSON W BLOMBERG
PLYMOUTH, MN
NPI
1003057118
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: MN 10560)
Enumeration Date
2009-03-19
Last Update Date
2022-07-21
Business Address
-- GRAYSON W BLOMBERG PA-C
15700 37TH AVE N STE 150
PLYMOUTH, MN 55446-3675
Phone number: 651-968-5201
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Mailing Address
-- GRAYSON W BLOMBERG PA-C
710 COMMERCE DR STE 200
WOODBURY, MN 55125-4925
Phone number: 651-968-5201
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