Individual
KATHRYN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
7015 KINGSWOOD RUN DR, ATLANTA, GA 30340-1865
(513) 967-5877
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
019451
KY
Other
Enumeration date
08/07/2017
Last updated
02/22/2023
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