| NPI | 1952849853 |
|---|---|
| Former Name | TRACY LYNN EWER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT004187) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-10 |