Individual
TRACY RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 WILLENE LN, SULPHUR, LA 70663-5543
(337) 842-6591
Mailing address
107 WILLENE LN, SULPHUR, LA 70663-5543
(337) 842-6591
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15730
LA
Other
Enumeration date
08/16/2014
Last updated
08/16/2014
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