Individual
MS. TRACEY E. HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
202 OPEKISKA RD, FAIRMONT, WV 26554-8753
(304) 612-4945
Mailing address
202 OPEKISKA RD, FAIRMONT, WV 26554-8753
(304) 612-4945
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 001565
WV
Other
Enumeration date
01/27/2011
Last updated
03/24/2011
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