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
- City
- New Brighton
- State
- Minnesota
- ZIP Code
- 55112-1789
- Phone
- (651) 628-9566
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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