Individual
TRACY MCWHORTER MARTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3 PROFESSIONAL PARK DR STE 21, JOHNSON CITY, TN 37604-6529
(423) 434-6300
(423) 434-6312
Mailing address
3 PROFESSIONAL PARK DR STE 21, JOHNSON CITY, TN 37604-6529
(423) 434-6300
(423) 434-6312
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3610
TN
363AS0400X
Surgical Physician Assistant
3610
TN
Other
Enumeration date
09/03/2010
Last updated
03/27/2019
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