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Individual

HEATHER LYNN TRACY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1137 HAMPTON PL, SALEM, OH 44460-1081
(330) 277-6078
Mailing address
1137 HAMPTON PL, SALEM, OH 44460-1081
(330) 277-6078

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
148749
OH

Other

Enumeration date
04/03/2013
Last updated
04/03/2013
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