Individual
TRACI S POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3320 4TH AVE STE F, CONWAY, SC 29527-6057
(843) 248-6550
Mailing address
538 S EADDY FORD RD, JOHNSONVILLE, SC 29555-5201
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36263
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71399D
—
SC
Enumeration date
09/14/2015
Last updated
12/28/2017
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