Individual
MR. TRACY BASLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT#5612
Contact information
Practice address
10348 FLAGSTAFF DR NW, ALBUQUERQUE, NM 87114-3544
(505) 307-9964
Mailing address
10348 FLAGSTAFF DR. NW, ALBUQUERQUE, NM 87114
(505) 307-9964
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5612
NM
Other
Enumeration date
06/08/2009
Last updated
06/08/2009
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