Individual
MS. TRACIE LYNN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
500 N CAPITOL AVE UNIT A, INDIANAPOLIS, IN 46204
(317) 983-5400
Mailing address
892 LONDON LANE APT 653, GREENWOOD, IN 46142
(574) 993-2415
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005656A
IN
225200000X
Physical Therapy Assistant
06005656A
—
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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