Individual
TRACEY L GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
3739 W HELENA DR, GLENDALE, AZ 85308-3105
(481) 414-6513
Mailing address
3739 W HELENA DR, GLENDALE, AZ 85308-3105
(480) 414-6513
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
06/09/2009
Last updated
06/09/2009
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