Individual
KIMBERLY PAULINE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
201 JOHN E DEVINE DR, MANCHESTER, NH 03103-4034
(603) 626-1233
Mailing address
201 JOHN E DEVINE DR, MANCHESTER, NH 03103-4034
(603) 626-1233
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHCY04534
NH
Other
Enumeration date
10/18/2018
Last updated
09/23/2021
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