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1467812164
TRACY GLENN EAGER
MEDFORD, OR
NPI
1467812164
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 94-10-88)
Enumeration Date
2016-02-24
Last Update Date
2018-11-02
Business Address
Mr. TRACY GLENN EAGER CADC 2
300 W MAIN ST
MEDFORD, OR 97501-2756
Phone number: 541-772-1777
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Mailing Address
Mr. TRACY GLENN EAGER CADC 2
300 W MAIN ST
MEDFORD, OR 97501-2756
Phone number: 541-772-1777
Copy
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