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Individual

TRACEE MICHELLE SHEPARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.A.

Contact information

Practice address
3120 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5043
(573) 651-8242
(573) 651-8246
Mailing address
275 MELISSAS DR, JACKSON, MO 63755-8813
(573) 587-2342

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
117109
MO

Other

Enumeration date
05/17/2017
Last updated
05/17/2017
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