Provider Demographics
NPI:1992712764
Name:HILL, TRACY LYNN (DPT)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:SOUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:9097 E DESERT COVE AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6279
Mailing Address - Country:US
Mailing Address - Phone:480-760-1199
Mailing Address - Fax:480-706-3999
Practice Address - Street 1:16611 S 40TH ST
Practice Address - Street 2:SUITE 130
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0562
Practice Address - Country:US
Practice Address - Phone:480-706-1199
Practice Address - Fax:480-706-3999
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ116051Medicare PIN