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Individual

TRACEY G NEEDHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
647 LIME CITY RD, ROSSFORD, OH 43460-1444
(419) 666-0700
(419) 666-9605
Mailing address
647 LIME CITY RD, ROSSFORD, OH 43460-1444
(419) 666-0700
(419) 666-9605

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5330T2239
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0854286
OH
Enumeration date
11/21/2006
Last updated
12/02/2013
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