Individual
TRACY MACINTYRE RAYKOVICZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2115 W ROOSEVELT BLVD, MONROE, NC 28110-2737
(704) 238-1849
(704) 238-1850
Mailing address
815 DEERCROSS LN, WAXHAW, NC 28173-6603
(704) 847-7474
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NC1894
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98478700
—
MD
Enumeration date
05/20/2006
Last updated
07/08/2007
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