Provider Demographics
NPI:1427144856
Name:JAMES, TRACY IVY (DC)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:IVY
Last Name:JAMES
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 888352
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30356-0352
Mailing Address - Country:US
Mailing Address - Phone:770-399-6772
Mailing Address - Fax:770-396-9363
Practice Address - Street 1:1720 MOUNT VERNON RD
Practice Address - Street 2:STE B
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4269
Practice Address - Country:US
Practice Address - Phone:770-399-6772
Practice Address - Fax:770-396-9363
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor