Individual
GRANT WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
524 ANDREW JOHNSON HIGHWAY, STRAWBERRY PLAINS, TN 37871
(865) 933-4149
(865) 933-4037
Mailing address
1270 MEADOWLANDS CR, SEVIERVILLE, TN 37876
(865) 253-2769
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
48112
TN
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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