Tracy Hannold
Individual provider Active NPI Physical Therapy Assistant · Stuart, VA
NPI 1356724926 · NPPES record last updated Jul 1, 2015
Key facts
- NPI
- 1356724926
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2306602347 (VA)
- Practice address
- 817 Woodland Drive
Stuart, VA 24171 - Phone
- (276) 694-8628
- NPI assigned
- Jul 1, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A3952 | NC | MD | Physical Therapy Assistant |
| 2306602347 | VA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2306602347 | VA | Yes |
| Physical Therapy Assistant | 225200000X | A3952 | NC |
Addresses
Primary practice location
817 Woodland Drive
Stuart, VA 24171
Mailing address
817 Woodland Drive
Stuart, VA 24171
Phone (276) 694-8628
Other providers in Stuart, VA
- Foresight Hospital and Health Systems
- FRG Virginia PC
- Allison Lynette Gammons
- Gary a Roberson PLLC
- Jorge G. Gonzalez
- Rebecca M Harris
- Hatcher&Hatcher Taxiservice
- Rebecca Hawks
- Paul C Herger
- Carolyn Jean Hicks
All providers in Stuart, VA · Physical Therapy Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.