Individual
TRACY SEGREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2305 KILLEARN CENTER BLVD, APT#C72, TALLAHASSEE, FL 32309-3518
(646) 919-2140
Mailing address
2305 KILLEARN CENTER BLVD, APT#C72, TALLAHASSEE, FL 32309-3518
(646) 919-2140
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PTA24022
FL
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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