Individual
TRACY LYNN VAN DE YACHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2900 CURRY LN, N.E.W. CURATIVE REHABILITATION, INC., GREEN BAY, WI 54311-5857
(920) 468-9129
(920) 965-2653
Mailing address
1513 BELLE HOLLOW LN, GREEN BAY, WI 54313-3210
(920) 434-0104
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
901-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40331900
—
WI
Enumeration date
10/11/2006
Last updated
07/08/2007
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