Individual
CARL WALLILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 SE 4TH ST, LAUREL, MT 59044-3324
(406) 628-8746
Mailing address
307 SE 4TH ST, LAUREL, MT 59044-3324
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2571
MT
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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