Physician Compare National (NPI:1366510349)

HEALTHCARE PROVIDER: TAMI LISA GRAVES PT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1366510349
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9436224045
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080815000688
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRAVES
	Individual professional last name
Provider First Name	TAMI
	Individual professional first name
Provider Middle Name	LISA
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	315 S ONEIDA AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	RHINELANDER
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	545013422
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y