Individual
TRACI L KILMARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP, CP
Contact information
Practice address
2108 E 3RD ST, SUITE 100, CHATTANOOGA, TN 37404-2600
(423) 267-0466
Mailing address
2108 E 3RD ST STE 100, CHATTANOOGA, TN 37404-2623
(423) 493-2395
(423) 493-2368
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
PRO183
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PRO183
TN PROSTHETIS LICENSE
TN
Enumeration date
11/19/2012
Last updated
11/18/2015
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