Provider Demographics
NPI:1891762654
Name:SEARS, TRACY G (PT)
Entity Type:Individual
Prefix:MR
First Name:TRACY
Middle Name:G
Last Name:SEARS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:TRACE
Other - Middle Name:
Other - Last Name:SEARS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:55 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803
Mailing Address - Country:US
Mailing Address - Phone:617-358-3700
Mailing Address - Fax:617-358-3710
Practice Address - Street 1:915 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-358-3700
Practice Address - Fax:617-358-3710
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist