Individual
STACIE MCCRACKEN PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4104 GIRVAN DR, MYRTLE BEACH, SC 29579-6888
(412) 916-1579
Mailing address
4104 GIRVAN DR, MYRTLE BEACH, SC 29579-6888
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12585
SC
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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