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Individual

TRACY POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
501 MARKET ST STE 2, LEWISBURG, PA 17837-3002
(570) 524-0900
Mailing address
RR 1 BOX 903, MIFFLINTOWN, PA 17059-9729

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN260498L
PA

Other

Enumeration date
06/21/2007
Last updated
07/08/2007
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