Individual
MRS. TRACEY LYNN ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
444 S MAIN ST, MADISONVILLE, KY 42431-2846
(270) 821-4999
(270) 821-0070
Mailing address
1415 OTTER LAKE LOOP, HANSON, KY 42413-9332
(270) 322-0756
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
013225
KY
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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