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Individual

KRISTOPHER WALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
3165 S 2ND ST, LOUISVILLE, KY 40208-1446
(502) 368-6153
(502) 368-6832
Mailing address
3165 S 2ND ST, LOUISVILLE, KY 40208-1446

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
021712
KY

Other

Enumeration date
11/04/2020
Last updated
11/04/2020
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