MEDICARE: TRACY ANN SEEL PA

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	363A00000X	Physician Assistant	4842080-1206	UT

General Provider Information

NPI Number	:	1326043225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY ANN SEEL PA

Provider Business Mailing Address
First Line	:	288 S PARADISE PARKWAY
Second Line	:	P.O. BOX 154
City	:	GARDEN CITY
State	:	UT
Zip	:	84028
Country	:	US
Telephone Number	:	435-255-1630
Fax Number	:	435-946-9124

Provider Business Practice Location Address
First Line	:	288 S PARADISE PARKWAY
Second Line	:	P.O. BOX 154
City	:	GARDEN CITY
State	:	UT
Zip	:	84028
Country	:	US
Telephone Number	:	435-255-1630
Fax Number	:	435-946-9124

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	12/10/2024

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