Individual
DR. MARILYNN R. WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
215 PERRY HILL RD, CAVHCS-119, MONTGOMERY, AL 36109
(334) 272-4670
Mailing address
6417 WYNWOOD PLACE, MONTGOMERY, AL 36117
(334) 272-4670
(334) 260-4133
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11078
AL
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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