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Individual

CRYSTAL WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1070 W LANDIS AVE, VINELAND, NJ 08360-3422
(856) 205-9354
Mailing address
360 CEDARWOOD DR, VINELAND, NJ 08360-7710

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03230900
NJ

Other

Enumeration date
02/02/2012
Last updated
02/02/2012
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