TRACY ELLIS, LMT

Contractor

Active Individual
NPI: 1649664442

Practice Address

157 W HAYDEN AVE
Hayden Lake, ID 83835

Phone: (509) 216-3663

Specialties

Specialty Code Primary License
Contractor 171W00000X Yes MAS-1492 (ID)

Frequently Asked Questions

NPI 1649664442 is the National Provider Identifier for TRACY ELLIS, LMT, a Contractor provider located in Hayden Lake, ID. This NPI was enumerated on March 19, 2015.
TRACY ELLIS, LMT practices at 157 W HAYDEN AVE, Hayden Lake, ID 83835.

Quick Facts

NPI
1649664442
Type
Individual
Enumerated
Mar 19, 2015
Last Updated
Mar 19, 2015

Nearby Providers