Individual
TRACEY BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOM
Contact information
Practice address
1209 SILVER AVE SW, ALBUQUERQUE, NM 87102-2843
(505) 730-0918
Mailing address
1209 SILVER AVE SW, ALBUQUERQUE, NM 87102-2843
(505) 730-0918
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1216
NM
225700000X
Massage Therapist
8363
NM
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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