Provider Demographics
NPI:1982459210
Name:ASARE, TRACY NANA (DC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:NANA
Last Name:ASARE
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 1:13803 BRIARWOOD DR APT 1813
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1352
Mailing Address - Country:US
Mailing Address - Phone:202-276-2476
Mailing Address - Fax:
Practice Address - Street 1:14201 LAUREL PARK DR STE 212
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:240-341-0005
Practice Address - Fax:240-341-0004
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor