Provider Demographics
NPI:1447567409
Name:CORDAY, TRACY LYNN (PT)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LYNN
Last Name:CORDAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 W TOWER PARK DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-9026
Mailing Address - Country:US
Mailing Address - Phone:319-233-6995
Mailing Address - Fax:319-233-7083
Practice Address - Street 1:815 W TOWER PARK DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-9026
Practice Address - Country:US
Practice Address - Phone:319-233-6995
Practice Address - Fax:319-233-7083
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist