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1184626996
TRACY CROCKETT
ATHENS, GA
NPI
1184626996
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: GA 1763)
Enumeration Date
2005-08-11
Last Update Date
2013-02-20
Business Address
-- TRACY CROCKETT P.A.
2470 DANIELS BRIDGE RD BLDG 200 SUITE 251
ATHENS, GA 30606-6187
Phone number: 706-389-3440
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Mailing Address
-- TRACY CROCKETT P.A.
1131 GOLF COURSE LN
ATHENS, GA 30605-5350
Phone number: 706-613-1518
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