Most Relevant Information
Provider Data
| NPI Number: | 1003075938 |
| Provider Name: | TINA MCRAE CMT |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/05/2008 |
| Last Updated: | 06/05/2008 |
Provider Practice Location
416 E HENNEPIN AVE
SUITE 202
MINNEAPOLIS
MN
554141006
Practice Location Phone/Fax
| Phone: | 6122512111 |
| Fax: | 6123795353 |
Provider Mailing Location
416 E HENNEPIN AVE
SUITE 202
MINNEAPOLIS
MN
554141006
Provider Mailing Phone/Fax
| Phone: | 6122512111 |
| Fax: | 6123795353 |