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Individual

TRACY JUDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8423 OLD STATE RD # A, HOLLY HILL, SC 29059-8100
(803) 759-3012
Mailing address
PO BOX 162, PO BOX 162, REEVESVILLE, SC 29471-0162
(843) 636-1001

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
53782
SC

Other

Enumeration date
05/02/2017
Last updated
05/02/2017
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