Individual
TRACEY EISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
751 UKROP DR, WILLIAMSBURG, VA 23187
(757) 221-3407
Mailing address
751 UKROP WAY, WILLIAMSBURG, VA 23187
(757) 221-3407
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001335
VA
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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