Individual
JOHN M TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
525 N. SANTIAM HIGHWAY, LEBANON, OR 97355-0739
(541) 451-7521
Mailing address
525 ORCHARD DRIVE WEST, MONMOUTH, OR 97361-1931
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1245
OR
Other
Enumeration date
02/05/2010
Last updated
02/05/2010
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