Individual
MR. DENNIS W TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
701 LEWISTON ST, COTTONWOOD, ID 83522
(208) 962-3251
(208) 962-3722
Mailing address
701 LEWISTON ST, COTTONWOOD, ID 83522
(208) 962-3251
(208) 962-3722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA201
ID
Other
Enumeration date
01/10/2007
Last updated
07/09/2007
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