Individual
TRACEY L ALCORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2200 IRONWOOD PL, COEUR D ALENE, ID 83814-2610
(208) 667-6486
Mailing address
PO BOX 1906, POST FALLS, ID 83877-1906
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-190
ID
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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