Provider Demographics
NPI:1073996369
Name:GRABRICK, KATHERINE (PTA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GRABRICK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:REMPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:604 1ST ST NE
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-1202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:604 1ST ST NE
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-1202
Practice Address - Country:US
Practice Address - Phone:651-466-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-04
Last Update Date:2015-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA1307225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant