Individual
RICHARD PAUL WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(401) 741-6547
Mailing address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH04611
RI
Other
Enumeration date
08/07/2012
Last updated
05/20/2025
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