Most Relevant Information
Provider Data
| NPI Number: | 1003404229 |
| Provider Name: | TRACY COWGER |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/04/2021 |
| Last Updated: | 01/04/2021 |
Provider Practice Location
144 7TH AVE
SOUTH CHARLESTON
WV
253031452
Practice Location Phone/Fax
| Phone: | 3047444081 |
| Fax: | 3047448606 |
Provider Mailing Location
144 7TH AVE
SOUTH CHARLESTON
WV
253031452
Provider Mailing Phone/Fax
| Phone: | 3047444081 |
| Fax: | 3047448606 |