Individual
TIMOTHY R TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T
Contact information
Practice address
1420 W ASHLEY RD, BOONVILLE, MO 65233-2112
(660) 882-6115
Mailing address
1420 W ASHLEY RD, BOONVILLE, MO 65233-2112
(660) 882-6115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2011020510
MO
Other
Enumeration date
08/22/2011
Last updated
08/22/2011
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