Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TRACY JO ELLIS, LMT
Active Sole ProprietorTRACY JO ELLIS, LMT is a Contractor healthcare provider located in HAYDEN LAKE, Idaho. NPI 1649664442 is currently active in the NPPES registry. Verify at CMS.
Contractor · HAYDEN LAKE, ID
Registration Details
- NPI Number
- 1649664442
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 19, 2015 (11.383227429191 yrs)
- Last Updated
- Mar 19, 2015
- License
-
MAS-1492 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
157 W HAYDEN AVEHAYDEN LAKE, ID, 838359650Browse ID providers · Browse ZIP 83835
- Phone
- 5092163663
- Primary Specialty
-
Contractor
171W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.