Provider Demographics
NPI:1588770986
Name:CARRIER, TRACEY LYNN (ATH)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:LYNN
Last Name:CARRIER
Suffix:
Gender:F
Credentials:ATH
Other - Prefix:
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Mailing Address - Street 1:23 BRIDGTON RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3653
Mailing Address - Country:US
Mailing Address - Phone:207-797-3477
Mailing Address - Fax:207-797-8577
Practice Address - Street 1:23 BRIDGTON RD
Practice Address - Street 2:SUITE 2
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3653
Practice Address - Country:US
Practice Address - Phone:207-797-3477
Practice Address - Fax:207-797-8577
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEAT2972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer