Individual
TRACEY EAGLEEYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14882 STATE ROUTE 13, THORNVILLE, OH 43076-8954
(740) 242-2300
Mailing address
PO BOX 894, CAMBRIDGE, OH 43725-0894
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OH
Other
Enumeration date
12/26/2020
Last updated
12/26/2020
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