Individual
KATHERYN RAE WALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201A S DIVISION ST, TRAVERSE CITY, MI 49684-4426
(231) 929-0526
Mailing address
1201A S DIVISION ST, TRAVERSE CITY, MI 49684-4426
(231) 929-0526
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5303045415
MI
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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