Individual
TRACY MARVIN BERG III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2700 DORR AVE APT 526, FAIRFAX, VA 22031-4946
(202) 246-0724
Mailing address
2700 DORR AVE APT 526, FAIRFAX, VA 22031-4946
(202) 246-0724
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019002906
VA
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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