Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | A06077 | IA |
Y | 213ER0200X | Radiology | A06077 | IA |
NPI | 1942410659 |
---|---|
Provider Name | Dr. Tracey Anne Littrell |
First Address | Wilton, IA 52778-9223 |
Second Address | Wilton, IA 52778-9223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 29/06/2014 |