Individual
DOMENICA BENINA WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 NELSON RD, NEW LENOX, IL 60451-2944
(815) 462-1998
Mailing address
475 NELSON RD, NEW LENOX, IL 60451-2944
(815) 462-1998
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
049.198980
IL
Other
Enumeration date
05/10/2020
Last updated
05/10/2020
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