Basic Information
| Provider Information | |||||||||
| NPI: | 1578732483 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCHATTON | ||||||||
| FirstName: | TRACY | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 MORGAN HWY | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | SCRANTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 185082641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705587410 | ||||||||
| FaxNumber: | 5702074287 | ||||||||
| Practice Location | |||||||||
| Address1: | 423 SCRANTON CARBONDALE HWY | ||||||||
| Address2: | |||||||||
| City: | SCRANTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 185081115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702075502 | ||||||||
| FaxNumber: | 5702075511 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2008 | ||||||||
| LastUpdateDate: | 02/25/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT002648E | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.