Individual
DR. PAUL DAVID TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
2316 BRIAR LN, QUINCY, IL 62305-6574
(816) 645-8025
(573) 406-1057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010425
IL
152W00000X
Optometrist
2001020432
MO
Other
Enumeration date
10/04/2007
Last updated
05/01/2014
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