Provider Demographics
NPI:1598106767
Name:GRABER, LAURA SUSAN (DC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:SUSAN
Last Name:GRABER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-2563
Mailing Address - Country:US
Mailing Address - Phone:720-438-5537
Mailing Address - Fax:507-645-8242
Practice Address - Street 1:205 DIVISION ST S
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-2014
Practice Address - Country:US
Practice Address - Phone:507-645-8242
Practice Address - Fax:507-645-8242
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program