Individual
MISS TRACY ANN GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1451 N 6TH ST, MILWAUKEE, WI 53212-3861
(414) 276-8332
(414) 276-8332
Mailing address
PO BOX 100702, MILWAUKEE, WI 53210-0702
(414) 234-1709
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/18/2018
Last updated
01/18/2018
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