Individual
TRACEY CIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 CLUB PL, DULUTH, GA 30096-8218
(954) 451-4116
Mailing address
2505 CLUB PL, DULUTH, GA 30096-8218
(954) 451-4116
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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