Individual
TRACEY CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12345 LAMPLIGHT VILLAGE AVE APT 127, AUSTIN, TX 78758-2551
(512) 590-0603
Mailing address
12345 LAMPLIGHT VILLAGE AVE APT 127, AUSTIN, TX 78758-2551
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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