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TRACY CROCKETT

Attendant Care Provider >> Technician >> Nursing Service Related Providers

Registrant NPI Number: 1568011807

Individual Registrant:
 TRACY  CROCKETT 
Gender: F
Sole Proprietor

Location and contact information for practice:
36408 COGNAC ST  WINCHESTER, CA 92596-9108 US
Tel: 951-926-6750  Fax: --

Contact information for business:
36408 COGNAC ST  WINCHESTER, CA 92596-9108 US
Tel: 951-926-6750  Fax: --

Registration Information:
NPI: 1568011807
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3747A0650XNursing Service Related Providers
Technician
Attendant Care Provider

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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