Individual
TRACY FATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15455 W BELL RD, SURPRISE, AZ 85374-3411
(623) 694-7222
Mailing address
16643 W QUAIL RUN RD, SURPRISE, AZ 85387-6280
(623) 694-7222
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
15483
AZ
225700000X
Massage Therapist
Primary
MT-15483
AZ
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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