Individual
NATHAN ANDREW WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
137 S MAIN ST, MILFORD, MA 01757-3258
(508) 478-1223
Mailing address
13 DARTMOOR DR, SHREWSBURY, MA 01545-1617
(717) 386-4634
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH236095
MA
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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