Individual
JESSICA WALLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 226-5992
Mailing address
225 DEERFIELD CT, NEW LENOX, IL 60451-2091
(815) 592-2439
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
03335183
OH
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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