Most Relevant Information
Provider Data
| NPI Number: | 1003325275 |
| Provider Name: | JENAH TRACY |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 1952 |
Most Important Dates
| Enumeration Date: | 09/20/2017 |
| Last Updated: | 09/20/2017 |
Provider Practice Location
700 PELHAM RD N
JACKSONVILLE
AL
362651602
Practice Location Phone/Fax
| Phone: | 2392279632 |
| Fax: |
Provider Mailing Location
213 DENT DR
NAPLES
FL
341125254
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |