Individual
MRS. TRACEE BLACKLOCK CAHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1700 WOODGATE DR, WOODWAY, TX 76712-8600
(254) 666-5454
Mailing address
621 S RUIDOSA DOWNS DR, ROBINSON, TX 76706-7254
(254) 662-3767
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
1051282
TX
Other
Enumeration date
09/27/2010
Last updated
09/27/2010
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