Individual
TRACIE M. MIMS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHARM. D., R.PH.
Contact information
Practice address
1123 BANKS MILL RD, AIKEN, SC 29803-2809
(803) 648-1313
Mailing address
907 WOODLAND DR, NEW ELLENTON, SC 29809-2812
(803) 648-1313
(803) 649-9494
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9641
SC
Other
Enumeration date
11/05/2005
Last updated
07/08/2007
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