Individual
VIVIAN ELAINE WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1048 STANTON RD STE B, DAPHNE, AL 36526-4236
(251) 626-2820
Mailing address
PO BOX 37, ORANGE BEACH, AL 36561-0037
(251) 978-5464
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12096
AL
Other
Enumeration date
11/12/2013
Last updated
05/26/2026
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