Individual
TRACY ALCORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055
Mailing address
1173 E HINES ST, REPUBLIC, MO 65738-1277
(417) 735-0055
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
2013017536
MO
Other
Enumeration date
08/03/2022
Last updated
11/14/2023
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