Tracy Leann Rider

NPI #1467171702 in Commerce, Oklahoma

Provider Information

NPI Number: 1467171702
Entity Type: Individual
Name: Tracy Leann Rider
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Aug 22, 2022
Last Updated: Aug 22, 2022

Practice Location

Address: 304 N MICKEY MANTLE BLVD
City: Commerce
State: Oklahoma
ZIP Code: 74339-1110
Phone: (918) 675-4100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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