Individual
TANNER TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-4353
Mailing address
6248 S ROCKROSE WAY, BOISE, ID 83716-7133
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3481219
ID
Other
Enumeration date
07/21/2026
Last updated
07/21/2026
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