Provider Demographics
NPI:1396970497
Name:ZIGLAR, TRACYE A (DPT)
Entity type:Individual
Prefix:
First Name:TRACYE
Middle Name:A
Last Name:ZIGLAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 NAT TURNER BLVD S
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2899
Mailing Address - Country:US
Mailing Address - Phone:757-596-1900
Mailing Address - Fax:
Practice Address - Street 1:250 NAT TURNER BLVD S
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2899
Practice Address - Country:US
Practice Address - Phone:757-596-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA192933OtherBCBS (PHYSICAL THERAPY)
VA1396970497Medicaid
VAP00709405OtherRAILROAD MEDICARE
VA9165336OtherAETNA
VA$$$$$$$$$-00OtherOHIO BUREAU OF WORKERS' COMPENSATION
VA019511T54Medicare PIN
VAP00709405OtherRAILROAD MEDICARE