PETER BLAKE GRANGAARD

ST LOUIS PARK, MN
NPI1356886733
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MN  12277)
Enumeration Date2016-12-21
Last Update Date2021-06-10
Business Address
PETER BLAKE GRANGAARD PA
3800 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Phone number: 952-993-3280
Mailing Address
PETER BLAKE GRANGAARD PA
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 55425-4516
Phone number:
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