Individual
IRA MCCRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
452 FOREST DR, MARSHFIELD, MO 65706-2413
(417) 872-8836
Mailing address
452 FOREST DR, MARSHFIELD, MO 65706-2413
(417) 872-8836
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2001018846
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001018846
MISSOURI BOARD OF PHARMACY
MO
Enumeration date
07/26/2018
Last updated
07/26/2018
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