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Individual

MR. ALLEN P (PHIL) WALLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
5706 BENJAMIN CENTER DR, SUITE 103, TAMPA, FL 33634-5262
(813) 514-0494
Mailing address
17937 BAHAMA ISLE DR, TAMPA, FL 33647-2777
(813) 982-9780

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
11362
TN
183500000X
Pharmacist
12123
NE
183500000X
Pharmacist
12646
GA
183500000X
Pharmacist
17435
LA
183500000X
Pharmacist
Primary
20125
FL
183500000X
Pharmacist
5302033233
MI
183500000X
Pharmacist
PD08997
AR

Other

Enumeration date
01/17/2007
Last updated
07/08/2007
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