TRACY FAMILY PRACTICE CLINIC PA

DE WITT, AR
NPI1659319150
Entity TypeOrganization
Authorized ContactWALLACE LEE TRACY
Owner
870-946-4505
Organization Subpart ?No
Primary Taxonomy305R00000X Preferred Provider Organization
(Licence: AR  C7340)
Enumeration Date2006-06-04
Last Update Date2010-09-16
Business Address
TRACY FAMILY PRACTICE CLINIC PA
1940 S WHITEHEAD DR
DE WITT, AR 72042-2906
Phone number: 870-946-4505
Mailing Address
TRACY FAMILY PRACTICE CLINIC PA
1940 S WHITEHEAD DR
DE WITT, AR 72042-2906
Phone number: 870-946-4505