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NPI Code Detail

MEDICARE: TRACY WEST MASSAGE THERAPIST

MEDICARE:   TRACY  WEST  MASSAGE THERAPIST
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
1225700000XMassage Therapist16650NC

General Provider Information

NPI Number : 1982281135
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY WEST MASSAGE THERAPIST
Provider Business Mailing Address
First Line : 4801 HARGROVE RD STE 104F
Second Line :
City : RALEIGH
State : NC
Zip : 27616-1949
Country : US
Telephone Number : 252-572-7961
Fax Number :
Provider Business Practice Location Address
First Line : 4801 HARGROVE RD STE 104F
Second Line :
City : RALEIGH
State : NC
Zip : 27616-1949
Country : US
Telephone Number : 252-572-7961
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2021
Last Update Date : 03/25/2021

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Directions to “ TRACY WEST MASSAGE THERAPIST” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.