MICAH JORDAN WALLACE

CHARLESTON, SC
NPI1003241571
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: SC  14060)
Additional Taxonomies183500000X Pharmacist
(Licence: TN  36630)
Enumeration Date2013-09-03
Last Update Date2013-09-03
Business Address
Dr. MICAH JORDAN WALLACE Pharm.D.
2152 SAVANNAH HWY
CHARLESTON, SC 29414-5311
Phone number: 843-556-8974
Mailing Address
Dr. MICAH JORDAN WALLACE Pharm.D.
2152 SAVANNAH HWY
CHARLESTON, SC 29414-5311
Phone number: 843-556-8974
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