Individual
DYLAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1106 ENVIRON WAY, CHAPEL HILL, NC 27517-4418
(919) 942-8738
Mailing address
515 S MANGUM ST, DURHAM, NC 27701-4384
(336) 583-8170
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
29900
NC
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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