Individual
BRANDY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E MCGALLIARD RD, MUNCIE, IN 47303-1166
(765) 288-6171
(765) 288-7308
Mailing address
100 E MCGALLIARD RD, MUNCIE, IN 47303-1166
(765) 288-6171
(765) 288-7308
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
67008185A
IN
Other
Enumeration date
01/09/2021
Last updated
01/09/2021
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