Individual
MRS. TRACY BLACKMON-PAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
732 DALMORE DR, FAYETTEVILLE, NC 28311-1133
(910) 494-4968
Mailing address
125 N REILLY RD, FAYETTEVILLE, NC 28303-2574
(910) 494-4968
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
C100052
NC
Other
Enumeration date
05/02/2016
Last updated
05/10/2016
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