Individual
MR. TRACY THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
321 NORRISTOWN RD, AMBLER, PA 19002-2755
(877) 636-9653
Mailing address
78 E GARFIELD ST, PHILADELPHIA, PA 19144-5935
(215) 844-0542
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
TE-005399-L
PA
Other
Enumeration date
06/03/2007
Last updated
07/08/2007
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