Individual
TRACI CHURCHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1114 WILLIAMS ST, DE SOTO, MO 63020-1148
(636) 375-8240
Mailing address
1114 WILLIAMS ST, DE SOTO, MO 63020-1148
(636) 375-8240
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2019027403
MO
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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