Stephanie Lynn Wallace

NPI #1023619061 in Pikeville, Kentucky

Provider Information

NPI Number: 1023619061
Entity Type: Individual
Name: Stephanie Lynn Wallace
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Nov 5, 2020
Last Updated: Nov 5, 2020

Practice Location

Address: 254 CASSIDY BLVD
City: Pikeville
State: Kentucky
ZIP Code: 41501-1426
Phone: (606) 432-6180

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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