Provider Demographics
NPI:1427428382
Name:BYRD, TRACEY
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-1758
Mailing Address - Country:US
Mailing Address - Phone:757-653-7220
Mailing Address - Fax:866-312-9765
Practice Address - Street 1:218 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1758
Practice Address - Country:US
Practice Address - Phone:757-653-7220
Practice Address - Fax:866-312-9765
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-04
Last Update Date:2015-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle