Individual
DR. TRACY A MCCUISTION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
430 N STATE ST, RIGBY, ID 83442-1240
(208) 745-7374
Mailing address
430 N STATE ST, RIGBY, ID 83442-1240
(208) 745-7374
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3449761202
UT
111N00000X
Chiropractor
Primary
CHIA-1404
ID
Other
Enumeration date
03/09/2006
Last updated
04/14/2010
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