GRANT STARK

FRIDLEY, MN
NPI1649960386
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: MN  528350)
Enumeration Date2023-05-08
Last Update Date2023-05-08
Business Address
GRANT STARK
5700 E RIVER RD
FRIDLEY, MN 55432-6149
Phone number: 763-571-3150
Mailing Address
GRANT STARK
150 40TH ST SE
MONTEVIDEO, MN 56265-4085
Phone number: 320-226-4131