Individual
DR. ELIZABETH MARY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
107 N MAIN ST, MARLBORO, NJ 07746-1062
(732) 972-2309
(732) 972-2529
Mailing address
155A GREENBROOK RD, GREEN BROOK, NJ 08812-2436
(732) 771-4185
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03296700
NJ
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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