Provider Demographics
NPI:1740689884
Name:BEYER, TRACY (LAT, ATC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:BEYER
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 JAMERSON ATHLETIC CTR
Mailing Address - Street 2:510 STADIUM ROAD
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24061-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9201 UNIVERSITY CITY BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28223-0001
Practice Address - Country:US
Practice Address - Phone:703-687-1058
Practice Address - Fax:703-687-5335
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer