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1649721895
GRANT DAVIS MITCHELL
FALCON HEIGHTS, MN
NPI
1649721895
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
273Y00000X Rehabilitation Unit
(Licence: 105222)
Enumeration Date
2016-10-21
Last Update Date
2016-10-21
Business Address
-- GRANT DAVIS MITCHELL MOTR/L
1412 IOWA AVE W
FALCON HEIGHTS, MN 55108-2124
Phone number: 218-407-0820
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Mailing Address
-- GRANT DAVIS MITCHELL MOTR/L
1412 IOWA AVE W
FALCON HEIGHTS, MN 55108-2124
Phone number: 218-407-0820
Copy