Individual
TRACEY ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 STODDARD RD, RICHMOND, MI 48062-2505
(810) 392-2167
Mailing address
1280 RANGE RD, PORT HURON, MI 48060-4673
(810) 956-7447
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
049685
MO
164W00000X
Licensed Practical Nurse
Primary
4703101737
MI
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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