Individual
DR. HOLLY MIRACLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D.
Contact information
Practice address
1410 N BROAD ST, TAZEWELL, TN 37879-4350
(423) 626-2344
(423) 626-2877
Mailing address
1410 NORTH BROAD STREET, TAZEWELL, TN 37879
(423) 626-2344
(423) 626-2877
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36151
TN
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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