Traci Churchill

NPI #1164295762 in De Soto, Missouri

Provider Information

NPI Number: 1164295762
Entity Type: Individual
Name: Traci Churchill
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Nov 6, 2023
Last Updated: Nov 6, 2023

Practice Location

Address: 1114 WILLIAMS ST
City: De Soto
State: Missouri
ZIP Code: 63020-1148
Phone: (636) 375-8240

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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