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Individual

MISS TRACEY JO LEMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
321 RUNAWAY BAY CIR, MISHAWAKA, IN 46545-8022
(574) 520-3937
Mailing address
321 RUNAWAY BAY CIRCLE, APT. 3D, MISHAWAKA, IN 46545

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001438A
IN

Other

Enumeration date
02/03/2010
Last updated
02/03/2010
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