Provider Demographics
NPI:1528469475
Name:SCHUETTE, TRACY LYNN
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LYNN
Last Name:SCHUETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 WINDTREE TRCE
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-2399
Mailing Address - Country:US
Mailing Address - Phone:708-846-1377
Mailing Address - Fax:
Practice Address - Street 1:1040 WINDTREE TRCE
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-2399
Practice Address - Country:US
Practice Address - Phone:708-846-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPTA0000005750225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant