Most Relevant Information
Provider Data
| NPI Number: | 1003650029 |
| Provider Name: | GORDON STRAM |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/24/2024 |
| Last Updated: | 06/24/2024 |
Provider Practice Location
1404 NW 4TH ST
GRAND RAPIDS
MN
557442212
Practice Location Phone/Fax
| Phone: | 2183270875 |
| Fax: |
Provider Mailing Location
1125 SW 1ST ST
GRAND RAPIDS
MN
557443407
Provider Mailing Phone/Fax
| Phone: | 2182590003 |
| Fax: |