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Grace Edith Line
Driver in Andover, Minnesota
NPI 1790318186

Grace Edith Line is a Driver based in Duluth, MN. Grace Edith Line practices in Andover, MN. The NPI Number for Grace Edith Line is 1790318186 and holds a License No. B772-020-465-216 (Minnesota).

The current practice location address for Grace Edith Line is 2934 168Th Ln Nw, Andover, MN and can be reached out via phone at 218-481-5357.

Location: 2934 168Th Ln Nw, Andover, MN, 55815-0192
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790318186
Provider Name
Grace Edith Line
Credential
Provider Entity Type
Individual
Gender
Female
Address
2934 168Th Ln Nw, Andover, MN, 55815-0192
Phone Number
218-481-5357
Fax Number
Provider Enumeration Date
02/13/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2934 168Th Ln Nw
City
Andover
State
Minnesota
Zip
55304-1928
Phone Number
218-481-5357
Fax Number
person
Provider Business Mailing Address Details
Address
2934 168Th Ln Nw
City
Andover
State
Minnesota
Zip
55304-1928
Phone Number
218-481-5357
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
172A00000X
License No.
B772-020-465-216 (Minnesota)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
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