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General NPI Number Information
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NPI Number | 1750504965
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Entity Type | Individual
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Provider Name | TRACY H. MAR P.T.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 815 STEWART DR
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City | SUNNYVALE
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State | CA
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Zip | 94085-4514
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Country | US
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Telephone | 408-737-2335
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Fax | 866-541-2651
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Provider Business Mailing Address
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Address Line | 918A DEWING AVE
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City | LAFAYETTE
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State | CA
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Zip | 94549-4223
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Country | US
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Telephone | 510-301-0147
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Fax | 866-541-2651
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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 | PT24449
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License Number State | CA
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