Provider Demographics
NPI:1801313267
Name:TRACY, SAVANNAH LEIGH (LAT, ATC)
Entity type:Individual
Prefix:MRS
First Name:SAVANNAH
Middle Name:LEIGH
Last Name:TRACY
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:LEIGH
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9707 DRY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2084
Mailing Address - Country:US
Mailing Address - Phone:830-305-5449
Mailing Address - Fax:
Practice Address - Street 1:9707 DRY CREEK CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2084
Practice Address - Country:US
Practice Address - Phone:830-305-5449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-26
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer