Provider Demographics
NPI:1033726484
Name:STEELE, TRACIE' L (LMT)
Entity Type:Individual
Prefix:
First Name:TRACIE'
Middle Name:L
Last Name:STEELE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 HILLBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2109
Mailing Address - Country:US
Mailing Address - Phone:804-441-3733
Mailing Address - Fax:
Practice Address - Street 1:4615 HILLBROOK AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-2109
Practice Address - Country:US
Practice Address - Phone:804-441-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019015788225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist