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Individual

TRACEY L PAVLICEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
363 15TH ST W, DICKINSON, ND 58601-3017
(701) 225-4434
(701) 225-0013
Mailing address
2260 3RD ST W, DICKINSON, ND 58601-2414
(701) 483-9299
(701) 225-0013

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4568
ND

Other

Enumeration date
02/15/2007
Last updated
07/08/2007
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