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1790547990
NATHAN REIDAR HOLST-GRUBBE
LEWISTON, ME
NPI
1790547990
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ME 2000054326)
Enumeration Date
2024-01-24
Last Update Date
2024-01-24
Business Address
NATHAN REIDAR HOLST-GRUBBE
141 RUSSELL ST
LEWISTON, ME 04240-6024
Phone number: 475-233-4445
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Mailing Address
NATHAN REIDAR HOLST-GRUBBE
141 RUSSELL ST
LEWISTON, ME 04240-6024
Phone number: 475-233-4445
Copy
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