Provider Demographics
NPI:1477604783
Name:KEEFER, TRACY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:ANN
Last Name:KEEFER
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 1:521 YOPP RD
Mailing Address - Street 2:STE 214 PMB 308
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540
Mailing Address - Country:US
Mailing Address - Phone:910-333-9723
Mailing Address - Fax:
Practice Address - Street 1:521 YOPP RD STE 107
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-3597
Practice Address - Country:US
Practice Address - Phone:910-333-9723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor