Provider Demographics
NPI:1780232769
Name:CRAMER, RACHEL (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:CRAMER
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 CHESTNUT LN NE
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-1184
Mailing Address - Country:US
Mailing Address - Phone:612-269-9716
Mailing Address - Fax:
Practice Address - Street 1:9220 BASS LAKE RD STE 350
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-3095
Practice Address - Country:US
Practice Address - Phone:763-208-9545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN32902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer