Individual
MISS STACY ANN WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
5 RIVER WALK MALL, SOUTH CHARLESTON, WV 25303-1026
(304) 744-5128
Mailing address
1800 ROUNDHILL RD APT 1403, CHARLESTON, WV 25314-1560
(304) 610-5384
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4295
WV
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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