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Individual
MRS. TRACI REVELS MCCOY
Active
Individual
MRS. TRACI REVELS MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
102190
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000662
—
AL
01
—
1730216417
NPI
—
Enumeration date
04/01/2010
Last updated
04/01/2010
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