Individual
TRACY LOGAN PERSILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
200 CAMPBELL DR STE 115, WILLINGBORO, NJ 08046-1067
(856) 536-1515
Mailing address
1 FEDERAL ST STE 200, CAMDEN, NJ 08103-1088
(848) 288-6935
(732) 790-0107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB09743400
NJ
Other
Enumeration date
07/26/2013
Last updated
10/08/2024
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