Individual
TRACY R BRAITHWAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 524, MORONI, UT 84646-0524
(435) 851-3459
Mailing address
PO BOX 524, MORONI, UT 84646-0524
(435) 851-3459
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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