Individual
DUANE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
665 3RD ST SW, PERHAM, MN 56573-1137
(218) 346-1169
(218) 346-1279
Mailing address
665 3RD ST SW, PERHAM, MN 56573-1137
(218) 346-1169
(218) 346-1279
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
114023
MN
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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