Organization
WOODVILLE PROFESSIONAL HEALTHCARE LLC
Active
Other names
Fremont Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TY N TRACY DC (OWNER)
(419) 334-7737
Entity
Organization
Contact information
Practice address
444 N STONE ST, FREMONT, OH 43420-1530
(419) 334-7737
(419) 334-2828
Mailing address
444 N STONE ST, FREMONT, OH 43420-1530
(419) 334-7737
(419) 334-2828
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2805
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362532
ANTHEM BCBS
OH
Enumeration date
12/04/2007
Last updated
10/18/2021
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