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NPI Code Detail

MEDICARE: MRS. TRACY ELLEN KWITOWSKI LPT

MEDICARE: MRS. TRACY ELLEN KWITOWSKI LPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist8716NC

General Provider Information

NPI Number : 1871577437
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACY ELLEN KWITOWSKI LPT
Provider Business Mailing Address
First Line : 1065 VINEHAVEN DR
Second Line :
City : CONCORD
State : NC
Zip : 28025-2439
Country : US
Telephone Number : 704-786-9181
Fax Number : 704-792-9198
Provider Business Practice Location Address
First Line : 1065 VINEHAVEN DR
Second Line :
City : CONCORD
State : NC
Zip : 28025-2439
Country : US
Telephone Number : 704-786-9181
Fax Number : 704-792-9198
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. TRACY ELLEN KWITOWSKI LPT” Practice Location

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