Individual
TRACY DIONE ADIGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DIRECTOR
Contact information
Practice address
2304 OAK LN # 201-203, GRAND PRAIRIE, TX 75051-8812
(940) 366-4027
Mailing address
2304 OAK LN # 201-203, GRAND PRAIRIE, TX 75051-8812
(940) 366-4027
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000000
NON-MEDICAL
—
Enumeration date
01/24/2020
Last updated
01/24/2020
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