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1952749582
TRACEY BASTIAANS
MOULTRIE, GA
NPI
1952749582
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
208200000X Plastic Surgery
(Licence: PA OT018067)
Enumeration Date
2013-06-05
Last Update Date
2024-11-20
Business Address
Dr. TRACEY BASTIAANS D.O.
4 LIVE OAK CT
MOULTRIE, GA 31768-6783
Phone number: 229-785-2400
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Mailing Address
Dr. TRACEY BASTIAANS D.O.
PO BOX 2876
MOULTRIE, GA 31776-2876
Phone number: 229-891-9131
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