Provider Demographics
NPI:1548319148
Name:GRAFF, TIMOTHY JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOSEPH
Last Name:GRAFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8635 OAKLAND AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-3029
Mailing Address - Country:US
Mailing Address - Phone:952-693-1387
Mailing Address - Fax:
Practice Address - Street 1:490 SNELLING AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1501
Practice Address - Country:US
Practice Address - Phone:651-699-6044
Practice Address - Fax:651-699-2065
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor