Tracy Roach
Technician, Attendant Care Provider in Sandersville, GA. Individual provider (NPI-1).
NPI number1164066809
StatusActive
Last updated in NPPESNov 6, 2019
Details
- NPI
- 1164066809
- Entity type
- Individual (NPI-1)
- Name
- Tracy Roach
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 6, 2019
- Last updated
- Nov 6, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
327 Harmony Church RdSandersville, GA 31082-9010
Phone 478-456-6647
Mailing address
327 Harmony Church RdSandersville, GA 31082-9010
Phone 478-456-6647
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