NPI 1104498344

Tracy Kellam

Practitioner Contractor Youngstown, OH

Practice location

Address: 4120 Euclid Blvd, Youngstown, OH 44512-1305
Phone: (330) 984-1505

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 0325993 (OH)

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Registry record

NPI: 1104498344
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Jul 2021
Record last updated: 16 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.