Individual
DR. ANTOINETTE DOLORES WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
150 PIERCE ST, SOMERSET, NJ 08873-4185
(888) 319-1818
Mailing address
1431 BARNHARDT LN, RAHWAY, NJ 07065-5084
(917) 345-5992
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03484900
NJ
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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