Mccormick, Tracy Gene

Mccormick, Tracy Gene is an individual health care provider with primary practice located at 820 E Grant St , Appleton WI 54911-3483. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Mccormick, Tracy Gene can be contacted via phone (920) 831-5050.

Contact Information

Primary practice address
820 E Grant St Appleton WI 54911-3483
Phone: (920) 831-5050
Fax: (920) 738-6400
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 290-039 Wisconsin

Profile Details

NPI number 1710014824
LBN Legal business name Mccormick, Tracy Gene
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1710014824 NPPES
Wisconsin Other 290-039 STATE LICENSE NUMBER

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