Most Relevant Information
Provider Data
| NPI Number: | 1003658030 |
| Provider Name: | TRACY ROSA LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 39265 |
Most Important Dates
| Enumeration Date: | 06/11/2024 |
| Last Updated: | 06/11/2024 |
Provider Practice Location
11745 W PICO BLVD
LOS ANGELES
CA
900641308
Practice Location Phone/Fax
| Phone: | 4244004057 |
| Fax: |
Provider Mailing Location
3756 CARDIFF AVE APT 206
LOS ANGELES
CA
900348807
Provider Mailing Phone/Fax
| Phone: | 3103651528 |
| Fax: |