Individual
TRACEY FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
15316 HUEBNER RD STE 202, SAN ANTONIO, TX 78248-0994
(210) 614-4567
Mailing address
15316 HUEBNER RD STE 202, SAN ANTONIO, TX 78248-0994
(210) 614-4567
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1107001
TX
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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