Provider Demographics
NPI:1144425968
Name:ROBERTS-RAMIREZ, TRACEY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:LYNN
Last Name:ROBERTS-RAMIREZ
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 1:201 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:DALLASTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17313-1507
Mailing Address - Country:US
Mailing Address - Phone:717-894-7165
Mailing Address - Fax:
Practice Address - Street 1:3700 NW 91ST ST STE B300
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7352
Practice Address - Country:US
Practice Address - Phone:352-441-6870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011727111N00000X
PAMSG004825174400000X
FLCH14259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No174400000XOther Service ProvidersSpecialist