Grace Line
NPI 1790318186 · on the registry since 2020
Practice
- Address
- 2934 168th Ln Nw
Andover, MN 55304 - Phone
- (218) 481-5357
Additional practice sites
- 6588 Fredenberg Lake Rd, Duluth, MN
Registry record
- Primary taxonomy
- Driver
172A00000X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-02-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota