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Individual

JAY FRANCIS TRACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, PSYD, LP

Contact information

Practice address
3915 GOLDEN VALLEY RD, COURAGE CENTER, GOLDEN VALLEY, MN 55422
(612) 588-0811
(763) 520-0355
Mailing address
3915 GOLDEN VALLEY RD, COURAGE CENTER, GOLDEN VALLEY, MN 55422
(612) 588-0811
(763) 520-0355

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8827
MN

Other

Enumeration date
03/27/2006
Last updated
07/08/2007
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