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Individual

JAMES WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5805 N POLK DR, KANSAS CITY, MO 64151-2691
(816) 505-3560
(816) 505-3560
Mailing address
8001 N. LINCOLN AVE, SUITE 800, SKOKIE, IL 60077-3695

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
041455
MO
183500000X
Pharmacist
1-15107
KS
183500000X
Pharmacist
27680
TX

Other

Enumeration date
06/05/2012
Last updated
06/05/2012
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