Individual
MS. PATRICIA TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
555 N NEW BALLAS RD, SUITE 120, SAINT LOUIS, MO 63141-6825
(314) 432-7100
(314) 432-7259
Mailing address
555 N NEW BALLAS RD, SUITE 120, SAINT LOUIS, MO 63141-6825
(314) 432-7100
(314) 432-7259
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01952
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158596
BLUE CROSS BLUE SHIELD
MO
01
—
508818
HEALTHLINK
MO
01
—
611900000
DEPT OF LABOR
MO
Enumeration date
12/13/2006
Last updated
09/15/2015
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