Provider Demographics
NPI:1760667745
Name:SELLERS, TRACEY WYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:WYNNE
Last Name:SELLERS
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:PO BOX 8142
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-1554
Mailing Address - Country:US
Mailing Address - Phone:704-594-4744
Mailing Address - Fax:
Practice Address - Street 1:615 S COLLEGE ST FL 10
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3355
Practice Address - Country:US
Practice Address - Phone:704-594-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor