Provider Demographics
NPI:1467695742
Name:MAGERUS, TRACY LEE (NMD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LEE
Last Name:MAGERUS
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 E SAHUARO DR STE 203
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6102
Mailing Address - Country:US
Mailing Address - Phone:480-454-5581
Mailing Address - Fax:833-297-4260
Practice Address - Street 1:7127 E SAHUARO DR STE 203
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6102
Practice Address - Country:US
Practice Address - Phone:480-454-5581
Practice Address - Fax:833-297-4260
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ09-1111175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath