Provider Demographics
NPI:1245520659
Name:GRONHOLZ, JUSTIN CURTIS (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:CURTIS
Last Name:GRONHOLZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15574 EDGEWOOD DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56401-6956
Mailing Address - Country:US
Mailing Address - Phone:218-829-2665
Mailing Address - Fax:218-829-4855
Practice Address - Street 1:15574 EDGEWOOD DR STE 102
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56401-6956
Practice Address - Country:US
Practice Address - Phone:218-829-2665
Practice Address - Fax:218-829-4855
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor