Individual
TATJANA A CHACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
225 E CLOUD AVE, ANDOVER, KS 67002-8824
(316) 706-2772
Mailing address
PO BOX 177, TOWANDA, KS 67144-0177
(316) 706-2772
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
14-02847
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-02847
KANSAS STATE BOARD OF PHARMACY
KS
Enumeration date
05/23/2021
Last updated
05/23/2021
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