MEDICARE: CHRISTOPHER TRACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1205783537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER TRACY

Provider Business Mailing Address
First Line	:	57 CRABTREE RD
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-3148
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 CRABTREE RD
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-3148
Country	:	US
Telephone Number	:	323-377-5447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “ CHRISTOPHER TRACY ” Practice Location

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