Doctor Name: | MS. KATHLEEN BRIDGET TRACY |
NPI Number: | 1033327960 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 9144 |
Business Practice Address: | 214 Lake St Child Development Building Shrewsbury, MA - 015453960 |
Business Phone Number: | 5088564202 |
Business Fax Number: | 5088452783 |
Mailing Address: | 10 Stoneland Rd, SHREWSBURY |
State: | MA |
Postal Code: | 015454451 |
Phone Number: | 5087532050 |
Fax Number: | 5088452783 |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 9144 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |