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Individual

CHAD A WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
208 ROXALANA BUSINESS PARK, DUNBAR, WV 25064-2727
(304) 720-6970
(304) 720-6963
Mailing address
112 MULBERRY DR, HURRICANE, WV 25526-8925
(304) 562-1821
(304) 720-6963

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0005705
WV

Other

Enumeration date
09/06/2006
Last updated
07/08/2007
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