Individual
TRACY M SHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCPT
Contact information
Practice address
266 LANCASTER AVE, SUITE 200, MALVERN, PA 19355-3256
(610) 640-4133
Mailing address
266 LANCASTER AVE, SUITE 200, MALVERN, PA 19355-3256
(610) 640-4133
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OC005515L
PA
Other
Enumeration date
10/30/2008
Last updated
10/30/2008
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