Ellis, Tracy Jo

Ellis, Tracy Jo is an sole proprietor health care provider with primary practice located at 157 W Hayden Ave , Hayden Lake ID 83835-9650. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Ellis, Tracy Jo can be contacted via phone (509) 216-3663.

Contact Information

Primary practice address
157 W Hayden Ave Hayden Lake ID 83835-9650
Phone: (509) 216-3663
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X MAS-1492 Idaho

Profile Details

NPI number 1649664442
LBN Legal business name Ellis, Tracy Jo
Credentials LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 19th, 2015
Last updated Mar 19th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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