Provider Demographics
NPI:1760428775
Name:SCHMITT, TRACIE L (PT,DPT)
Entity Type:Individual
Prefix:MRS
First Name:TRACIE
Middle Name:L
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5612 POPLAR LAKES LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-5756
Mailing Address - Country:US
Mailing Address - Phone:502-727-1012
Mailing Address - Fax:
Practice Address - Street 1:6003 PLEASANT COLONY CT
Practice Address - Street 2:SUITE 3
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-8678
Practice Address - Country:US
Practice Address - Phone:502-241-5597
Practice Address - Fax:502-241-6499
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004553225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist