NPI 1093098063

Kristie L Meacheam Wallace, RPH

Practitioner Pharmacist Ozark, MO

Practice location

Address: 2004 W Marler Ln, Ozark, MO 65721-7661
Phone: (417) 581-3288
Mailing address: 1039 E Maryland CT, Springfield, MO 65810-2982

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 044157 (MO)

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Registry record

NPI: 1093098063
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Sep 2011
Record last updated: 22 Dec 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.