Individual
TRACY L ALTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1421 PREMIER DR, MANKATO CLINIC AT WICKERSHAM CAMPUS, MANKATO, MN 56001
(507) 625-1811
Mailing address
PO BOX 8674, 1230 E MAIN ST MANKATO CLINIC LTD, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
7567
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026K9OL
BCBS
MN
05
—
086605900
—
MN
01
—
1832781
AMERICAS PPO
MN
01
—
41084933956001C208
CHAMPUS
—
01
—
4500237
MEDICA
MN
01
—
640004790
RR MEDICARE
—
01
—
HP40596
HEALTH PARTNERS
MN
01
—
NA2951023870
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
07/09/2020
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