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1689197113
SHANE TRACY
MEDFORD, OR
NPI
1689197113
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA187850)
Enumeration Date
2017-07-17
Last Update Date
2022-10-05
Business Address
Mr. SHANE TRACY PA-C
2780 E BARNETT RD STE 200
MEDFORD, OR 97504
Phone number: 541-779-6250
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Mailing Address
Mr. SHANE TRACY PA-C
2780 E BARNETT RD STE 200
MEDFORD, OR 97504-8674
Phone number: 541-779-6250
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