Individual
CARISSA MARIE TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1248 AUSTIN HWY STE 210, SAN ANTONIO, TX 78209-4867
(210) 646-8008
Mailing address
8031 CANTURA MLS, CONVERSE, TX 78109-3267
(210) 595-6438
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1189650
TX
Other
Enumeration date
01/06/2009
Last updated
07/23/2009
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