Individual
MRS. TRACY LYNN SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
920 JUDSON RD, MASURY, OH 44438-1242
(330) 307-5498
Mailing address
920 JUDSON RD, MASURY, OH 44438-1242
(330) 307-5498
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
02797
OH
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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