Individual
TRACY LEE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3220 IRVIN COBB DR, PADUCAH, KY 42003-2196
(270) 442-6404
(270) 442-0743
Mailing address
3220 IRVIN COBB DR, PADUCAH, KY 42003-2196
(270) 442-6404
(270) 442-0743
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
010307
KY
Other
Enumeration date
11/08/2020
Last updated
11/08/2020
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