Individual
VIVIAN WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 E AZALEA AVE, FOLEY, AL 36535-2540
(251) 424-1563
Mailing address
PO BOX 7825, GULF SHORES, AL 36547-7825
(251) 424-1563
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12096
AL
Other
Enumeration date
11/12/2013
Last updated
11/12/2013
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