Individual
SHAUNA TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
12 N MAIN ST, RANDOLPH, VT 05060-1127
(802) 728-3722
Mailing address
12 N MAIN ST, RANDOLPH, VT 05060-1127
(802) 728-3722
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
033.0078551
VT
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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