MR. Grant Gullickson, PA-C

NPI #1770279408 in New Brighton, Minnesota

Provider Information

NPI Number
1770279408
Entity Type
Individual
Name
MR. Grant Gullickson, PA-C
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant
Credential
PA-C
Enumeration Date
Apr 14, 2023
Last Updated
Apr 14, 2023

Practice Location

Address
1900 SILVER LAKE RD NW STE 110
ZIP Code
55112-1789
Phone
(651) 628-9566

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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