Individual
TRACEY LYNETTE COWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 COUNTY ROAD 534, RIPLEY, MS 38663-9113
(662) 587-2412
Mailing address
21 COUNTY ROAD 534, RIPLEY, MS 38663-9113
(662) 587-2412
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
04/22/2013
Last updated
06/03/2013
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