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NPI Code Detail

MEDICARE: DR. TRACY DAVID COLE D.C.

MEDICARE:  DR. TRACY DAVID COLE  D.C.
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
1111N00000XChiropractor20865CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932113982
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACY DAVID COLE D.C.
Provider Business Mailing Address
First Line : PO BOX 1072
Second Line :
City : CRESCENT CITY
State : CA
Zip : 95531-1072
Country : US
Telephone Number : 707-464-2921
Fax Number : 707-464-2131
Provider Business Practice Location Address
First Line : 785 E WASHINGTON BLVD
Second Line : STE 5
City : CRESCENT CITY
State : CA
Zip : 95531-8372
Country : US
Telephone Number : 707-464-2921
Fax Number : 707-464-2131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 02/24/2021

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Directions to “ DR. TRACY DAVID COLE D.C.” Practice Location

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