Provider Demographics
NPI:1699859256
Name:HARTFORD, TRACY L (DC)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:L
Last Name:HARTFORD
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 1:1735 E UNIVERSITY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5204
Mailing Address - Country:US
Mailing Address - Phone:334-826-2225
Mailing Address - Fax:334-826-2254
Practice Address - Street 1:1735 E UNIVERSITY DR STE 103
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5204
Practice Address - Country:US
Practice Address - Phone:334-826-2225
Practice Address - Fax:334-826-2254
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1374111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000022157Medicare ID - Type Unspecified
ALU31122Medicare UPIN