Individual
TRACIE FORTNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9816 VINE ST, LAKESIDE, CA 92040-3119
(619) 905-9251
Mailing address
9757 MARILLA DR APT 204, LAKESIDE, CA 92040-2862
(619) 905-9251
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
25412
CA
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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