Provider Demographics
NPI:1447309257
Name:LE, TRACY THU (DC)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:THU
Last Name:LE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2324 MONTPELIER DR
Mailing Address - Street 2:SUITE #7
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1612
Mailing Address - Country:US
Mailing Address - Phone:408-729-3099
Mailing Address - Fax:408-729-3098
Practice Address - Street 1:2324 MONTPELIER DR
Practice Address - Street 2:SUITE #7
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1612
Practice Address - Country:US
Practice Address - Phone:408-729-3099
Practice Address - Fax:408-729-3098
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor