Individual
MISS TRACY LYNNE BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
123 MEADOW HILL LN, SINKS GROVE, WV 24976-9892
(304) 646-5991
Mailing address
123 MEADOW HILL LN, SINKS GROVE, WV 24976-9892
(304) 646-5991
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2020-3814
WV
Other
Enumeration date
04/24/2022
Last updated
04/24/2022
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