Individual
GRACE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1801 N 14TH AVE, DODGE CITY, KS 67801-2302
(620) 225-6095
(620) 225-6578
Mailing address
1801 N 14TH AVE, DODGE CITY, KS 67801-2302
(620) 225-6095
(620) 225-6578
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-103349
KS
Other
Enumeration date
08/22/2020
Last updated
08/22/2020
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