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1417707563
ELLEN GUSTAFSON
MINNEAPOLIS, MN
NPI
1417707563
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MN 14847)
Enumeration Date
2024-03-22
Last Update Date
2024-06-04
Business Address
ELLEN GUSTAFSON
701 PARK AVE
MINNEAPOLIS, MN 55415-1623
Phone number: 612-873-6963
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Mailing Address
ELLEN GUSTAFSON
701 PARK AVE
MINNEAPOLIS, MN 55415-1623
Phone number: 612-873-3000
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