Individual
WILLIAM LEE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
308 S MAIN ST, MALVERN, AR 72104-3737
(501) 467-8197
(501) 467-8662
Mailing address
308 S MAIN ST, MALVERN, AR 72104-3737
(501) 467-8197
(501) 467-8662
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH07329
AR
Other
Enumeration date
08/22/2020
Last updated
08/22/2020
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