Individual
MRS. TRACY LYNN BOESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4782 HOSPITAL DR, CASS CITY, MI 48726-1049
(989) 872-2174
(989) 872-2204
Mailing address
1125 RIDGE RD, SEBEWAING, MI 48759-9756
(810) 853-8992
(989) 872-2204
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001175
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5502001175
—
MI
Enumeration date
11/02/2013
Last updated
11/02/2013
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