Individual
TY N TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
444 N STONE ST, FREMONT, OH 43420-1530
(419) 334-7737
(419) 334-2528
Mailing address
444 N STONE ST, FREMONT, OH 43420-1530
(419) 334-7737
(419) 334-2528
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2805
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362534
ANTHEM BCBS
OH
05
—
2117220
—
OH
01
—
7139412
AETNA
—
Enumeration date
07/24/2006
Last updated
01/18/2022
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