Provider Demographics
NPI:1063103372
Name:GRATZ CARLIN, CHRISTIANNA (PT)
Entity type:Individual
Prefix:
First Name:CHRISTIANNA
Middle Name:
Last Name:GRATZ CARLIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTIANNA
Other - Middle Name:
Other - Last Name:GRATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1157 DEVONSHIRE CURV
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-3192
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:333 SMITH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2344
Practice Address - Country:US
Practice Address - Phone:651-241-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist