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Individual

TRACY FREDERICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1200 GARDEN VIEW RD STE 220, ENCINITAS, CA 92024-2475
(858) 249-6890
Mailing address
5060 SHOREHAM PL STE 330, SAN DIEGO, CA 92122-5976
(858) 249-6890

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
76212
CA

Other

Enumeration date
02/12/2019
Last updated
02/12/2019
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