Provider Demographics
NPI:1730942251
Name:FEHRING, TRACY NICOLE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:NICOLE
Last Name:FEHRING
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:TRACY
Other - Middle Name:NICOLE
Other - Last Name:LOUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6153 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-4948
Mailing Address - Country:US
Mailing Address - Phone:720-556-6664
Mailing Address - Fax:
Practice Address - Street 1:315 W SOUTH BOULDER RD STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1157
Practice Address - Country:US
Practice Address - Phone:303-666-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist