Provider Demographics
NPI:1578513974
Name:HILL, TRACY ANN (PT)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:ANN
Other - Last Name:POLLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2607 BRAEMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-2535
Mailing Address - Country:US
Mailing Address - Phone:636-561-8440
Mailing Address - Fax:
Practice Address - Street 1:5933 S HIGHWAY 94
Practice Address - Street 2:SUITE 204
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-5610
Practice Address - Country:US
Practice Address - Phone:636-300-4300
Practice Address - Fax:636-300-4301
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist