Individual
MRS. TRACY A REESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1722 SHAFFER STREET, SUITE 3, KALAMAZOO, MI 49048
(269) 226-5197
(269) 552-0910
Mailing address
1722 SHAFFER ST., SUITE 3, KALAMAZOO, MI 49048
(269) 226-5197
(269) 552-0910
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601004897
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601004897
MICHIGAN LICENSE
MI
Enumeration date
10/12/2006
Last updated
03/15/2023
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