Individual
BROOKE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3601 S 6TH AVE, TUCSON, AZ 85723-0001
(520) 792-1450
Mailing address
13561 PUEBLO, TUSTIN, CA 92782-8327
(949) 331-5128
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
88682
CA
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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