Individual
MRS. TRACY STIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
376 MANCHESTER SQUARE, MANCHESTER, KY 40962-9998
(606) 598-7673
(606) 598-7942
Mailing address
PO BOX 555, MANCHESTER, KY 40962
(606) 598-3836
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0370
KY
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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