Individual
MRS. TRACY LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFTS
Contact information
Practice address
2309 S 17TH ST STE 100, WILMINGTON, NC 28401-8006
(910) 392-5806
(910) 397-2867
Mailing address
8504 LAKEVIEW DR, WILMINGTON, NC 28412-3397
(910) 599-7077
(910) 397-2867
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CFTS0582
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CFTS0582
ABC
NC
Enumeration date
08/27/2009
Last updated
08/27/2009
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