Individual
JENAH TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 PELHAM RD N, JACKSONVILLE, AL 36265-1602
(239) 227-9632
Mailing address
213 DENT DR, NAPLES, FL 34112-5254
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1952
AL
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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