Individual
TRACI WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
4310 OUTER LOOP, LOUISVILLE, KY 40219-3853
(502) 962-2876
(502) 966-5674
Mailing address
4310 OUTER LOOP, LOUISVILLE, KY 40219-3853
(502) 962-2876
(502) 966-5674
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
011277
KY
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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