Individual
MRS. TRACY LEIGH VISCOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
401 S QUEEN ST, MARTINSBURG, WV 25401-3233
(304) 264-3500
Mailing address
401 S QUEEN ST, MARTINSBURG, WV 25401-3233
(304) 264-3500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0159742000
WV
Other
Enumeration date
10/15/2007
Last updated
10/15/2007
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