Individual
TRACY JO THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4201 SAINT ANTOINE ST, SUITE 4C, DETROIT, MI 48201-2153
(313) 745-4755
(313) 993-0085
Mailing address
3800 WOODWARD AVE, SUITE 600, DETROIT, MI 48201-2061
(313) 262-1309
(313) 262-1238
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704169739
MI
Other
Enumeration date
06/08/2006
Last updated
07/19/2011
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