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Individual
TY N TRACY
Active
Individual
TY N TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2805
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362534
ANTHEM BCBS
OH
05
—
2117220
—
OH
01
—
7139412
AETNA
—
Enumeration date
07/24/2006
Last updated
01/18/2022
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