Provider Demographics
NPI:1316091788
Name:ANDREWS, TAMI RAE (DC)
Entity type:Individual
Prefix:DR
First Name:TAMI
Middle Name:RAE
Last Name:ANDREWS
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 1:3511 LAKE ELMO AVE N
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-8469
Mailing Address - Country:US
Mailing Address - Phone:651-779-7858
Mailing Address - Fax:651-777-2426
Practice Address - Street 1:3511 LAKE ELMO AVE N
Practice Address - Street 2:
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-8469
Practice Address - Country:US
Practice Address - Phone:651-779-7858
Practice Address - Fax:651-777-2426
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4C876LAOtherBCBS PROVIDER ID