Provider Demographics
NPI:1528325958
Name:RATHAI, TAMI LYNN (CMT)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:LYNN
Last Name:RATHAI
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16190 HIGHWAY 7
Mailing Address - Street 2:SUITE A
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3403
Mailing Address - Country:US
Mailing Address - Phone:952-933-2400
Mailing Address - Fax:952-933-2406
Practice Address - Street 1:16190 HIGHWAY 7
Practice Address - Street 2:SUITE A
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3403
Practice Address - Country:US
Practice Address - Phone:952-933-2400
Practice Address - Fax:952-933-2406
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist