Individual
THERESA MARIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
2701 S MINNESOTA AVE STE 1, SIOUX FALLS, SD 57105-4787
(605) 367-2800
Mailing address
2701 S MINNESOTA AVE STE 1, SIOUX FALLS, SD 57105-4787
(605) 367-2800
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6685
SD
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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