Tracee Depriest

NPI #1902929243 in Glen Carbon, Illinois

Provider Information

NPI Number: 1902929243
Entity Type: Individual
Name: Tracee Depriest
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Apr 10, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 15 JUNCTION DR
City: Glen Carbon
State: Illinois
ZIP Code: 62034-4300
Phone: (618) 659-9666

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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