Provider Demographics
NPI:1790275642
Name:LOYNES, TRACY
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:LOYNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 N SQUIRREL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4601
Mailing Address - Country:US
Mailing Address - Phone:248-652-5900
Mailing Address - Fax:248-475-2263
Practice Address - Street 1:2251 N SQUIRREL RD STE 101
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-4601
Practice Address - Country:US
Practice Address - Phone:248-652-5900
Practice Address - Fax:248-475-2263
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist