Individual
MRS. TRACY VAN ELLS MOISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
105 HALTON VILLAGE CIR STE A, GREENVILLE, SC 29607-6832
(864) 234-1433
(864) 286-1462
Mailing address
105 HALTON VILLAGE CIR, STE A, GREENVILLE, SC 29607-6832
(864) 234-1433
(864) 286-1462
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1977
SC
Other
Enumeration date
07/20/2007
Last updated
05/30/2019
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