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MR. TRACY HUGH TIPPETS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPA

Contact information

Practice address
240 OAK LN, KAYSVILLE, UT 84037-1635
(801) 543-1301
Mailing address
240 OAK LN, KAYSVILLE, UT 84037-1635
(801) 543-1301

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
09 UT 1-14
UT
2471C3402X
Radiography Radiologic Technologist
119162-5401
UT

Other

Enumeration date
12/18/2008
Last updated
12/18/2008
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