MS. Jacqueline Wallace

NPI #1518200740 in Windsor, Colorado

Provider Information

NPI Number: 1518200740
Entity Type: Individual
Name: MS. Jacqueline Wallace
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Apr 6, 2013
Last Updated: Apr 6, 2013

Practice Location

Address: 1520 MAIN ST
City: Windsor
State: Colorado
ZIP Code: 80550-7909
Phone: (970) 674-2840

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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