Provider Demographics
NPI:1073505434
Name:MULLINARY, TRACEY L (DC)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:L
Last Name:MULLINARY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8670 PEEBLES RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5722
Mailing Address - Country:US
Mailing Address - Phone:412-366-5474
Mailing Address - Fax:
Practice Address - Street 1:8670 PEEBLES RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5722
Practice Address - Country:US
Practice Address - Phone:412-366-5474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC8609L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA200751218OtherCOMMERICAL PAYORS
PA1557186OtherBCBS
PA1557186OtherBCBS
PA200751218OtherCOMMERICAL PAYORS