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Individual

DR. RHETT JAY WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
Mailing address
11554 PECAN WAY, LOMA LINDA, CA 92354-3530
(707) 496-8696

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
4317
WY

Other

Enumeration date
05/18/2022
Last updated
07/25/2022
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