Individual
MRS. TRACEY L PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACHELOR OF ARTS
Contact information
Practice address
1407 SAINT ANDREW ST, SUITE 100, LA CROSSE, WI 54603-3301
(608) 785-5908
Mailing address
W7855 BROADMOOR PARK DR, HOLMEN, WI 54636-8402
(608) 526-4450
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
7500-120
WI
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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