Individual
CAROLYN ELYCE TROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3216 E CLEAR LAKE AVE, SPRINGFIELD, IL 62702-6208
(217) 544-7948
Mailing address
3216 E CLEAR LAKE AVE, SPRINGFIELD, IL 62702-6208
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.304261
IL
Other
Enumeration date
09/04/2021
Last updated
09/14/2021
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