Individual
TRACY ALMA BETTENCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2235 TACKETTS MILL DR UNIT C, WOODBRIDGE, VA 22192-3036
(703) 491-1044
Mailing address
2101 MILL RD APT 110, ALEXANDRIA, VA 22314-5318
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2305214986
VA
Other
Enumeration date
05/19/2022
Last updated
05/19/2022
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