Provider Demographics
NPI:1801900477
Name:PARPART, TRACY A (DC)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:A
Last Name:PARPART
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 1:7567 CENTRAL PARKE BLVD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:513-229-3150
Mailing Address - Fax:513-229-3152
Practice Address - Street 1:7567 CENTRAL PARKE BLVD.
Practice Address - Street 2:SUITE B
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-229-3150
Practice Address - Fax:513-229-3152
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0921186Medicaid
OHU11980Medicare UPIN