Provider Demographics
NPI:1689950990
Name:HARDY, TRACY ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:ELIZABETH
Last Name:HARDY
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 1:5219 NW 76TH CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-8045
Mailing Address - Country:US
Mailing Address - Phone:386-717-0076
Mailing Address - Fax:352-732-6781
Practice Address - Street 1:1007 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0920
Practice Address - Country:US
Practice Address - Phone:352-732-2745
Practice Address - Fax:352-732-8006
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor