Individual
CHRISTY TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1815 AMERICAN LEGION BLVD STE A, MOUNTAIN HOME, ID 83647-3166
(208) 571-2111
Mailing address
1815 AMERICAN LEGION BLVD STE A, MOUNTAIN HOME, ID 83647-3166
(208) 571-2111
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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