Provider Demographics
NPI:1427451277
Name:HUTCHINS, TRACI (PT)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TRACI
Other - Middle Name:
Other - Last Name:HERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1411 WEST COUNTY LINE RD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142
Mailing Address - Country:US
Mailing Address - Phone:800-486-4449
Mailing Address - Fax:317-886-5027
Practice Address - Street 1:3700 LAFAYETTE PARKWAY
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119
Practice Address - Country:US
Practice Address - Phone:812-923-4888
Practice Address - Fax:502-415-7175
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INC5005026A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist