Provider Demographics
NPI:1164617932
Name:GRABER, TRACY L (RRT)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:L
Last Name:GRABER
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3920 13TH AVE E
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3675
Mailing Address - Country:US
Mailing Address - Phone:218-263-7540
Mailing Address - Fax:866-732-0699
Practice Address - Street 1:225 SMITH AVE N
Practice Address - Street 2:SUITE 301
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2533
Practice Address - Country:US
Practice Address - Phone:651-288-5180
Practice Address - Fax:651-288-5188
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN2486227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered