Individual
JACQUEL WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3489 RAMILL RD, MEMPHIS, TN 38128-3328
(901) 372-8422
(901) 386-8113
Mailing address
3489 RAMILL RD, MEMPHIS, TN 38128-3328
(901) 372-8422
(901) 386-8113
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42528
TN
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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