KENNIS HAL WALLACE

HARRISBURG, IL
NPI1811981939
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: IL  051028035)
Enumeration Date2005-09-02
Last Update Date2007-07-08
Business Address
-- KENNIS HAL WALLACE RPH
303 S COMMERCIAL ST PARKER PLAZA
HARRISBURG, IL 62946-2125
Phone number: 618-253-7621
Mailing Address
-- KENNIS HAL WALLACE RPH
303 S COMMERCIAL ST PARKER PLAZA
HARRISBURG, IL 62946-2125
Phone number: 618-253-7621
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