Individual
JESSICA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2200 SW GAGE BLVD, TOPEKA, KS 66622-0001
(785) 350-4404
Mailing address
727 ACORN ST, EUDORA, KS 66025-9681
(913) 980-0510
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-100038
KS
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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