Individual
TRACY R SHRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
(931) 380-1111
Mailing address
3803 RHEA BRANCH RD, ETHRIDGE, TN 38456-7080
(931) 424-1867
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2616
TN
Other
Enumeration date
02/04/2007
Last updated
07/08/2007
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