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General NPI Number Information
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NPI Number | 1114431384
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Entity Type | Individual
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Provider Name | CATHERINE TRACY PT
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Gender | Female
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 11/27/2017
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Provider Practice Location Address
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Address Line | 70 BUTLER ST
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City | SALEM
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State | NH
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Zip | 03079-3925
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Country | US
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Telephone | 774-452-0966
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Fax |
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Provider Business Mailing Address
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Address Line | 123 NEW BOSTON RD
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City | STURBRIDGE
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State | MA
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Zip | 01566-1015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 23376
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License Number State | MA
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