Individual
MS. TRACY ELIZABETH GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
5600 POST ROAD, SUITE 116, EAST GREENWICH, RI 02818
(401) 885-0069
(401) 885-0071
Mailing address
100 HARTSHORN ROAD, PROVIDENCE, RI 02906
(401) 885-0069
(401) 885-0071
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01111
RI
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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