Individual
TRACY CONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSSD
Contact information
Practice address
77 NEALY AVENUE, 633D MEDICAL GROUP, JOINT BASE LANGLEY-EUSTIS, VA 23665-2040
(757) 225-7630
Mailing address
77 NEALY AVENUE, 633D MEDICAL GROUP, JOINT BASE LANGLEY-EUSTIS, VA 23665-2040
(757) 225-7630
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
835002
VA
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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