Individual
TRACY NICOLE WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, LAT, ATC
Contact information
Practice address
14564 HAREWOOD CT, JACKSONVILLE, FL 32258-1718
(904) 307-9514
Mailing address
14564 HAREWOOD CT, JACKSONVILLE, FL 32258-1718
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
PTA23153
FL
2255A2300X
Athletic Trainer
Primary
AL 2689
FL
Other
Enumeration date
03/12/2007
Last updated
06/20/2018
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