Provider Demographics
NPI:1740443274
Name:MCGLAMERY, TRACY LYNN (LPTA)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:MCGLAMERY
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 MCNEIL RD
Mailing Address - Street 2:
Mailing Address - City:MILLERS CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:28651-8577
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-2732
Practice Address - Country:US
Practice Address - Phone:336-838-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2659225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant