Provider Demographics
NPI:1487258877
Name:TRACHTE, AMY MAY (DPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MAY
Last Name:TRACHTE
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 1:34 W PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-3753
Mailing Address - Country:US
Mailing Address - Phone:949-285-0271
Mailing Address - Fax:
Practice Address - Street 1:34 W PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3753
Practice Address - Country:US
Practice Address - Phone:949-285-0271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4824225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist