Individual
TRACY POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
5000 S 13TH ST, LEAVENWORTH, KS 66048-5581
(913) 290-7257
Mailing address
605 MCCLELLAN AVE, FORT LEAVENWORTH, KS 66027-1308
(913) 364-5156
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18162
IA
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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