Individual
TRACY MARIE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
510 TOWNE DR, SUITE 100, FAYETTEVILLE, NY 13066-1331
(315) 637-4747
(315) 637-6711
Mailing address
510 TOWNE DR, SUITE 100, FAYETTEVILLE, NY 13066-1331
(315) 637-4747
(315) 637-6711
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006022-1
NY
Other
Enumeration date
07/07/2006
Last updated
07/08/2007
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