Individual
TRACY S HEPBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 767-2672
Mailing address
504 SHOOTINGSTAR ST, COLUMBUS, GA 31907-6397
(786) 859-2762
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PHTC010502
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
09/25/2014
Last updated
09/25/2014
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