Individual
TRACY K NIBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1401 PHAY AVE, CANON CITY, CO 81212-2303
(719) 275-8656
Mailing address
3045 STRATMOOR DR, CANON CITY, CO 81212-9340
(719) 406-7234
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0014952
CO
Other
Enumeration date
04/02/2021
Last updated
04/02/2021
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