Individual
AUDREY C WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
5026 W US HIGHWAY 52, NEW PALESTINE, IN 46163-9770
(317) 861-4838
Mailing address
1836 N 300 W, GREENFIELD, IN 46140-8425
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03440267
OH
183500000X
Pharmacist
Primary
26029026A
IN
Other
Enumeration date
11/29/2020
Last updated
11/29/2020
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