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Tracy Jo Ellis, LMT
Contractor in Hayden Lake, Idaho
NPI 1649664442

Tracy Jo Ellis is a Contractor based in Rathdrum, ID. Tracy Jo Ellis practices in Hayden Lake, ID and has the professional credentials of LMT. The NPI Number for Tracy Jo Ellis is 1649664442 and holds a License No. MAS-1492 (Idaho).

The current practice location address for Tracy Jo Ellis is 157 W Hayden Ave, Hayden Lake, ID and can be reached out via phone at 509-216-3663.

Location: 157 W Hayden Ave, Hayden Lake, ID, 83858-7502
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649664442
Provider Name
Tracy Jo Ellis
Credential
LMT
Provider Entity Type
Individual
Gender
Female
Address
157 W Hayden Ave, Hayden Lake, ID, 83858-7502
Phone Number
509-216-3663
Fax Number
Provider Enumeration Date
03/19/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
157 W Hayden Ave
City
Hayden Lake
State
Idaho
Zip
83835-9650
Phone Number
509-216-3663
Fax Number
person
Provider Business Mailing Address Details
Address
157 W Hayden Ave
City
Hayden Lake
State
Idaho
Zip
83835-9650
Phone Number
509-216-3663
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Contractor
Speciality
-
Taxonomy
171W00000X
License No.
MAS-1492 (Idaho)
Definition
A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).
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