Provider Demographics
NPI:1598521254
Name:LINDER, TRACY
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:LINDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 ELMIRA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-2412
Mailing Address - Country:US
Mailing Address - Phone:937-270-3598
Mailing Address - Fax:
Practice Address - Street 1:3208 ATHERTON RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-1205
Practice Address - Country:US
Practice Address - Phone:937-768-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach