Individual
TRACY CHRISTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 S STATE ST, SALT LAKE CITY, UT 84190-0001
(801) 468-2009
Mailing address
1582 PARK PL N, SALT LAKE CITY, UT 84121-1240
(801) 468-2063
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
261QR0405X
UT
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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