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Individual

ROBIN CATHERINE TRACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, ATC

Contact information

Practice address
1425 S COLUMBIA RD, GRAND FORKS, ND 58201-4039
(701) 746-8374
(701) 780-0885
Mailing address
PO BOX I, PARK RIVER, ND 58270-0708
(701) 284-4570
(701) 284-4581

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
972
ND
2255A2300X
Athletic Trainer
137-94
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013166
PREFERRED ONE GROUP # PT
ND
05
125177500
MN
01
12670
BCBS ND PT
ND
05
50668
ND
05
54206
ND
01
7B137PA
BCBS MN PT
MN
Enumeration date
10/23/2006
Last updated
09/27/2023
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