Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 209.019362 | IL |
NPI | 1003470865 |
---|---|
Provider Name | Mrs. Tracy L Bier |
First Address | Hillsdale, IL 61257-0073 |
Second Address | Moline, IL 61265-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2019 |
Last Update Date | 26/04/2019 |