Krystal A Wallis, PHARM D

NPI #1720334329 in Brockport, New York

Provider Information

NPI Number: 1720334329
Entity Type: Individual
Name: Krystal A Wallis, PHARM D
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: PHARM D
Enumeration Date: Aug 1, 2012
Last Updated: Jun 5, 2013

Practice Location

Address: 6265 BROCKPORT SPENCERPORT RD
City: Brockport
State: New York
ZIP Code: 14420-2605
Phone: (585) 637-2341

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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