Individual
TRACIE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2584 SHEFFIELD RD, JEFFERSON, OH 44047-9748
(440) 789-0307
Mailing address
2584 SHEFFIELD RD, JEFFERSON, OH 44047-9748
(440) 789-0307
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400917170509
OH
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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