Doctor Name: | DR. GRANT RILEY GUGISBERG |
NPI Number: | 1043436934 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DVM |
License Number: | 09490 |
Business Practice Address: | 837 Sibley Memorial Hwy Mendota Heights, MN - 551181709 |
Business Phone Number: | 6515520848 |
Business Fax Number: | |
Mailing Address: | 14141 44th St S, AFTON |
State: | MN |
Postal Code: | 550019652 |
Phone Number: | 6513412476 |
Fax Number: | |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 04/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174M00000X |
License Number: | 09490 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Veterinarian |
Taxonomy Specialization: | |
Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |