Individual
ANDREA BROOKE MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM. D
Contact information
Practice address
915 N BROAD ST, NEW TAZEWELL, TN 37825-6633
(423) 626-5511
(423) 626-5544
Mailing address
915 N BROAD ST, NEW TAZEWELL, TN 37825-6633
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
014669
KY
183500000X
Pharmacist
Primary
33135
TN
Other
Enumeration date
11/10/2011
Last updated
11/18/2011
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