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1023619061
STEPHANIE LYNN WALLACE
PIKEVILLE, KY
NPI
1023619061
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: KY 011733)
Enumeration Date
2020-11-05
Last Update Date
2020-11-05
Business Address
STEPHANIE LYNN WALLACE
254 CASSIDY BLVD
PIKEVILLE, KY 41501-1426
Phone number: 606-432-6180
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Mailing Address
STEPHANIE LYNN WALLACE
108 SANDY ST
PIKEVILLE, KY 41501-2002
Phone number: 606-899-5738
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