Bloedorn, Traci Rae
Bloedorn, Traci Rae is an sole proprietor health care provider with primary practice located at N8380 Old Highway 47 , Black Creek WI 54106-9152. She recently has only one registered license in Other Service Providers / Reflexologist, which is considered as her primary health care specialty. Bloedorn, Traci Rae can be contacted via phone (920) 525-3011.Contact Information
Primary practice address
N8380 Old Highway 47
Black Creek WI 54106-9152
Phone: (920) 525-3011
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Reflexologist | 173C00000X | BO1207 | Wisconsin |
Profile Details
| NPI number | 1679705909 |
|---|---|
| LBN Legal business name | Bloedorn, Traci Rae |
| Credentials | ARCB |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2009 |
| Last updated | Aug 20th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679705909 | NPPES |
| Wisconsin | Other | BO1207 | ARCB NATIONAL CERTIFICATION NUMBER BO1207 |
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