Individual
MISS TRACIE ANNE THOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 SOUTH AVE, GARDEN CITY, NY 11530-4213
(516) 237-8508
Mailing address
43 WILLIS AVENUE, FLORAL PARK, NY 11001-1621
(516) 237-8508
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
020602043
NY
Other
Enumeration date
12/24/2007
Last updated
10/26/2009
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